Healthcare Provider Details

I. General information

NPI: 1497641294
Provider Name (Legal Business Name): KARLA M. COLON LEBRON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 HARLEY STRICKLAND BLVD
ORANGE CITY FL
32763-7963
US

IV. Provider business mailing address

5066 GRAND TETON CT
DELAND FL
32724-0010
US

V. Phone/Fax

Practice location:
  • Phone: 386-457-6327
  • Fax:
Mailing address:
  • Phone: 939-419-3688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number9585735
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: