Healthcare Provider Details

I. General information

NPI: 1932847076
Provider Name (Legal Business Name): LUIS ALBERTO COLON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. HEMANAS DAVILA, CALLE J 9
BAYAMON PR
00960
US

IV. Provider business mailing address

600 AVE FERNANDEZ JUNCOS APT 207
SAN JUAN PR
00907-3134
US

V. Phone/Fax

Practice location:
  • Phone: 787-622-5420
  • Fax:
Mailing address:
  • Phone: 787-244-4820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number23386
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: