Provider Demographics
NPI:1114023645
Name:COLON-AVILES, ORLANDO J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:J
Last Name:COLON-AVILES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1572
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1572
Mailing Address - Country:US
Mailing Address - Phone:787-877-2500
Mailing Address - Fax:787-877-2505
Practice Address - Street 1:ROAD 110 KM 12.4
Practice Address - Street 2:2ND FLOOR COLON PLAZA BUILDING
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-2500
Practice Address - Fax:787-877-2505
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2139OtherPLAN DE SERVICIOS DE SALU
PR6843OtherINTERNATIONAL MED CARD
PR206799OtherPREFERRED HEALTH
PR26258OtherAMERICAN HEALTH
PR70356OtherPREFERRED MEDICARE CHOICE
PR41986OtherSSS
PR041734OtherCRUZ AZUL