Provider Demographics
NPI:1598768061
Name:COLON-VAZQUEZ, VICTOR J (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:J
Last Name:COLON-VAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7947
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7947
Mailing Address - Country:US
Mailing Address - Phone:787-747-2530
Mailing Address - Fax:787-747-2530
Practice Address - Street 1:TORRE HOSPITAL HIMA SUITE 122
Practice Address - Street 2:AVE LUIS MUNOZ RIVERA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-747-2530
Practice Address - Fax:787-747-2530
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13117207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0090115Medicare PIN
PR90115Medicare PIN