Provider Demographics
NPI:1962486423
Name:COLON, JOSE ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALBERTO
Last Name:COLON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:164 CALLE PITIRRE
Mailing Address - Street 2:MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7103
Mailing Address - Country:US
Mailing Address - Phone:787-287-0054
Mailing Address - Fax:787-281-6691
Practice Address - Street 1:431 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3418
Practice Address - Country:US
Practice Address - Phone:787-751-5170
Practice Address - Fax:787-281-6691
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2021-06-02
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Provider Licenses
StateLicense IDTaxonomies
PR6039207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR98598Medicare ID - Type Unspecified
PRD08782Medicare UPIN