MEDICARE: DANIEL T COLOMBO MD

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	208000000X	Pediatrics Physician	9889	NV
2	208000000X	Pediatrics Physician	ME149568	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568750933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL T COLOMBO MD

Provider Business Mailing Address
First Line	:	9679 LAKE NONA VILLAGE PL STE 101
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7310
Country	:	US
Telephone Number	:	407-261-2934
Fax Number	:	407-636-7811

Provider Business Practice Location Address
First Line	:	9679 LAKE NONA VILLAGE PL STE 101
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7310
Country	:	US
Telephone Number	:	407-261-2934
Fax Number	:	407-636-7811

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

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	11/01/2022

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Directions to “ DANIEL T COLOMBO MD” Practice Location

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