Provider Demographics
NPI:1861550428
Name:CARLO - COLON, MITZARIE ANN (AUD, PHD)
Entity type:Individual
Prefix:DR
First Name:MITZARIE
Middle Name:ANN
Last Name:CARLO - COLON
Suffix:
Gender:F
Credentials:AUD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PROGRAMA DOCTORAL EN AUDIOLOGIA - EPS, U.PR
Mailing Address - Street 2:PO BOX 365067
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-765-6540
Practice Address - Street 1:CLINICA DE LA ESCUELA DE MEDICINA
Practice Address - Street 2:REPARTO METROPOLITANO SHOPPING CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-7910
Practice Address - Fax:787-625-1966
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR592231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist