Provider Demographics
NPI:1437149432
Name:COLON, OSVALDO E (MD)
Entity Type:Individual
Prefix:
First Name:OSVALDO
Middle Name:E
Last Name:COLON
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 759
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0759
Mailing Address - Country:US
Mailing Address - Phone:787-857-7090
Mailing Address - Fax:
Practice Address - Street 1:CALLE EL PARQUE 17
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-0759
Practice Address - Country:US
Practice Address - Phone:787-857-7090
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6534208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics