Healthcare Provider Details

I. General information

NPI: 1689659088
Provider Name (Legal Business Name): JOSE R. COLON PEREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOSE R COLON MD

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 CALLE AMERICO SALAS STE 202
SAN JUAN PR
00909-2139
US

IV. Provider business mailing address

PO BOX 8340
SAN JUAN PR
00910-0340
US

V. Phone/Fax

Practice location:
  • Phone: 787-723-2202
  • Fax: 787-723-1955
Mailing address:
  • Phone: 787-723-2202
  • Fax: 787-723-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number008262
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number008262
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number008262
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number008262
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number008262
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number008262
License Number StatePR
# 7
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number8262
License Number StatePR
# 8
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number008262
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: