Provider Demographics
NPI:1376648014
Name:COLON-PEREZ, RENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:
Last Name:COLON-PEREZ
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:PO BOX 366257
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6257
Mailing Address - Country:US
Mailing Address - Phone:787-765-5479
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:SUITE 1010 CARR 165 KM 1.2 # 48
Practice Address - Street 2:CITY PLAZA
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-6704
Practice Address - Country:US
Practice Address - Phone:787-758-9200
Practice Address - Fax:787-848-0318
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2012-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9262207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084684Medicare ID - Type Unspecified