Provider Demographics
NPI:1043439870
Name:COLON-PENA, ARISTIDES (MD,)
Entity Type:Individual
Prefix:MR
First Name:ARISTIDES
Middle Name:
Last Name:COLON-PENA
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 10007 SUITE 408
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785
Mailing Address - Country:US
Mailing Address - Phone:787-595-2880
Mailing Address - Fax:
Practice Address - Street 1:CALLE BARBOSA
Practice Address - Street 2:55 SUR
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15049207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR002-2508Medicare ID - Type Unspecified
PRI-21360Medicare UPIN