Provider Demographics
NPI:1265850341
Name:COLON, MARCOS THOMAS (MD)
Entity Type:Individual
Prefix:MR
First Name:MARCOS
Middle Name:THOMAS
Last Name:COLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:615 E PRINCETON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1468
Mailing Address - Country:US
Mailing Address - Phone:407-898-6005
Mailing Address - Fax:407-898-7722
Practice Address - Street 1:615 E PRINCETON ST STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1468
Practice Address - Country:US
Practice Address - Phone:407-898-6005
Practice Address - Fax:407-898-7722
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55975208000000X
FLME144012208000000X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics