Provider Demographics
NPI:1104001270
Name:COLTON, PEDRO E (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:E
Last Name:COLTON
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 1:611 CALLE PAVIA
Mailing Address - Street 2:PAVIA MEDICAL PLAZA SUITE 214
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2239
Mailing Address - Country:US
Mailing Address - Phone:787-726-7008
Mailing Address - Fax:
Practice Address - Street 1:611 CALLE PAVIA
Practice Address - Street 2:PAVIA MEDICAL PLAZA SUITE 214
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2239
Practice Address - Country:US
Practice Address - Phone:787-726-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17532207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology