Provider Demographics
NPI:1780884163
Name:COLON-BORRERO, ADA M (MD)
Entity type:Individual
Prefix:DR
First Name:ADA
Middle Name:M
Last Name:COLON-BORRERO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:805 OAKLEY SEAVER DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1968
Mailing Address - Country:US
Mailing Address - Phone:352-536-8234
Mailing Address - Fax:407-513-9234
Practice Address - Street 1:805 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1968
Practice Address - Country:US
Practice Address - Phone:352-536-8234
Practice Address - Fax:407-513-9234
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2017-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR16814208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice