Healthcare Provider Details

I. General information

NPI: 1255033429
Provider Name (Legal Business Name): JONATHAN JOEL PEREZ-COLON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13067 N TELECOM PKWY
TEMPLE TERRACE FL
33637-0926
US

IV. Provider business mailing address

1 CALLE POPPY APT A9
SAN JUAN PR
00926-6346
US

V. Phone/Fax

Practice location:
  • Phone: 813-773-6658
  • Fax:
Mailing address:
  • Phone: 787-925-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME182905
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: