Healthcare Provider Details

I. General information

NPI: 1144228594
Provider Name (Legal Business Name): ALBERTO MANUEL COLON-ALVARADO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 5516 KM 0.1
ADJUNTAS PR
00601
US

IV. Provider business mailing address

PO BOX 37
ADJUNTAS PR
00601-0037
US

V. Phone/Fax

Practice location:
  • Phone: 787-829-1626
  • Fax: 787-829-1665
Mailing address:
  • Phone: 787-829-1626
  • Fax: 787-829-1665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number12010
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: