Provider Demographics
NPI:1780677914
Name:COLON PEREZ, MIGUEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:A
Last Name:COLON PEREZ
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 270259
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-3059
Mailing Address - Country:US
Mailing Address - Phone:787-281-7120
Mailing Address - Fax:787-281-7140
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:LA TORRE DE PLAZA SUITE 902
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-281-7120
Practice Address - Fax:787-281-7140
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7534207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77770Medicare UPIN
PR0082477Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER