Healthcare Provider Details

I. General information

NPI: 1881332104
Provider Name (Legal Business Name): DR. MANUEL ALFONSO COLON TERRON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CALLE FALCON
SAN JUAN PR
00926-9535
US

IV. Provider business mailing address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

V. Phone/Fax

Practice location:
  • Phone: 787-478-8509
  • Fax:
Mailing address:
  • Phone: 787-844-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number27591
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: