Provider Demographics
NPI:1841289451
Name:VALE COLON, OSCAR E (MD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:E
Last Name:VALE COLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1858
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1858
Mailing Address - Country:US
Mailing Address - Phone:787-877-1990
Mailing Address - Fax:787-818-5973
Practice Address - Street 1:CARR. 111 EDIFICIO VALE COLON
Practice Address - Street 2:OFICINA NUM 6
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-1990
Practice Address - Fax:787-818-5973
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
PR10376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF18938Medicare UPIN
PR82568Medicare ID - Type UnspecifiedMEDICARE NUMBER