Provider Demographics
NPI:1497384846
Name:COLON, ALEXZAVIER (MD)
Entity Type:Individual
Prefix:
First Name:ALEXZAVIER
Middle Name:
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 1:7502 SW 60TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6467
Mailing Address - Country:US
Mailing Address - Phone:352-433-0133
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:7502 SW 60TH AVE STE B
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6467
Practice Address - Country:US
Practice Address - Phone:352-433-0133
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21868208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice