Healthcare Provider Details

I. General information

NPI: 1649555186
Provider Name (Legal Business Name): JESSENIA COLON BONES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 ORLANDO CENTRAL PKWY STE 480
ORLANDO FL
32809-5785
US

IV. Provider business mailing address

1606 GAINES MILL CT APT 102
KISSIMMEE FL
34747-5193
US

V. Phone/Fax

Practice location:
  • Phone: 407-382-9079
  • Fax:
Mailing address:
  • Phone: 787-404-9618
  • Fax: 833-901-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY12106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: