Provider Demographics
NPI:1841257763
Name:COLBERG, PEDRO NELSON (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:NELSON
Last Name:COLBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 SAN PATRICIO AVE
Mailing Address - Street 2:MARAMAR PLAZA, SUITE 840
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-706-8341
Mailing Address - Fax:787-706-5223
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE 602
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-250-8341
Practice Address - Fax:787-765-1591
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2024-11-27
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Provider Licenses
StateLicense IDTaxonomies
PR82582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR067909OtherCRUZ AZUL PROVIDER NUMBER
PR81144OtherTRIPLE S
PR158896600OtherOWCP PROVIDER NUMBER
PRE-75034Medicare UPIN