MEDICARE: DR. MANUEL J COLON-MENDEZ 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	207P00000X	Emergency Medicine Physician	127869	FL
2	208100000X	Physical Medicine & Rehabilitation Physician	127869	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	:	1659366797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL J COLON-MENDEZ MD

Provider Business Mailing Address
First Line	:	1714 PENRITH LOOP
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-4250
Country	:	US
Telephone Number	:	787-617-7310
Fax Number	:

Provider Business Practice Location Address
First Line	:	10920 MOSS PARK RD STE 218
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-6087
Country	:	US
Telephone Number	:	407-730-5600
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	11/02/2023

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