MEDICARE: NELSON COLON MD PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	11290	PR

General Provider Information

NPI Number	:	1023080611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NELSON COLON MD PSC

Provider Business Mailing Address
First Line	:	1801 AVE PONCE DE LEON, SUITE 312
Second Line	:	SANTURCE MEDICAL MALL
City	:	SAN JUAN
State	:	PR
Zip	:	00909-2649
Country	:	US
Telephone Number	:	787-977-4383
Fax Number	:	787-722-5362

Provider Business Practice Location Address
First Line	:	1801 AVE PONCE DE LEON, SUITE 312
Second Line	:	SANTURCE MEDICAL MALL
City	:	SAN JUAN
State	:	PR
Zip	:	00909-2649
Country	:	US
Telephone Number	:	787-977-4383
Fax Number	:	787-722-5362

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NELSON COLON
Credential	:	MD
Telephone Number	:	787-977-4383

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	08/27/2014

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