MEDICARE: CHRISTINA COLONNA

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	235Z00000X	Speech-Language Pathologist	026682	NY
2	235Z00000X	Speech-Language Pathologist	SA20292	FL

General Provider Information

NPI Number	:	1447703665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA COLONNA

Provider Business Mailing Address
First Line	:	4200 N OCEAN DR APT 2-105
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-2831
Country	:	US
Telephone Number	:	917-864-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 SANDTREE DR STE 210C
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1538
Country	:	US
Telephone Number	:	917-864-0119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	10/02/2023

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Directions to “ CHRISTINA COLONNA ” Practice Location

Language	Start Address	Practice Location

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