Provider Demographics
NPI:1801251301
Name:SANTOS COLON, ILEAN M (DC)
Entity type:Individual
Prefix:
First Name:ILEAN
Middle Name:M
Last Name:SANTOS COLON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 WOODBURY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4505
Mailing Address - Country:US
Mailing Address - Phone:407-440-0026
Mailing Address - Fax:407-440-0027
Practice Address - Street 1:857 WOODBURY RD STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4505
Practice Address - Country:US
Practice Address - Phone:407-440-0026
Practice Address - Fax:407-440-0027
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor