Provider Demographics
NPI:1659462224
Name:COLON RIVERA, ORLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:
Last Name:COLON RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ORLANDO
Other - Middle Name:
Other - Last Name:COLON RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:#2043 CALLE GANIVET
Mailing Address - Street 2:EL SENORIAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:939-940-7314
Mailing Address - Fax:
Practice Address - Street 1:#2043 CALLE GANIVEL
Practice Address - Street 2:EL SENORIAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-940-7314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10264208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82856OtherTRIPLE-S
PRF47578Medicare UPIN