Provider Demographics
NPI:1710680533
Name:COLON, DENNIS (DPT)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:COLON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 5TH AVE N UNIT 2201
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7654
Mailing Address - Country:US
Mailing Address - Phone:727-776-3446
Mailing Address - Fax:
Practice Address - Street 1:111 2ND AVE NE STE 1401
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3480
Practice Address - Country:US
Practice Address - Phone:727-258-7224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist