Provider Demographics
NPI:1568432417
Name:COLON, ANA MARIA (OTR)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:COLON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8867 NW 108TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4508
Mailing Address - Country:US
Mailing Address - Phone:305-466-1388
Mailing Address - Fax:
Practice Address - Street 1:2962C AVENTURA BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3103
Practice Address - Country:US
Practice Address - Phone:305-466-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2117225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888727600Medicare ID - Type Unspecified
FLE6451VMedicare ID - Type Unspecified