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General NPI Number Information
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NPI Number | 1164785127
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Entity Type | Individual
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Provider Name | LUIS ALEXIS COLON LCNA
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Gender | Male
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Dates
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Enumeration Date | 06/24/2012
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Last Update Date | 06/24/2012
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Provider Practice Location Address
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Address Line | 231 NE 28TH AVE LOT 103
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City | OCALA
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State | FL
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Zip | 34470-1236
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Country | US
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Telephone | 352-804-4131
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Fax |
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Provider Business Mailing Address
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Address Line | 231 NE 28TH AVE LOT 103
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City | OCALA
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State | FL
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Zip | 34470-1236
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Country | US
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Telephone | 352-804-4131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA 124555
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License Number State | FL
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