Healthcare Provider Details

I. General information

NPI: 1346971207
Provider Name (Legal Business Name): MARIA COLON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 NE 2ND AVE
MIAMI FL
33137-2706
US

IV. Provider business mailing address

5200 NE 2ND AVE FL 3
MIAMI FL
33137-2706
US

V. Phone/Fax

Practice location:
  • Phone: 305-762-9236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberAPRN11020058
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: