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General NPI Number Information
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NPI Number | 1730182312
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Entity Type | Individual
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Provider Name | JOSE ENRIQUE COLON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 4683 VAN DYKE RD
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City | LUTZ
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State | FL
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Zip | 33558-4880
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Country | US
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Telephone | 813-968-7171
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Fax | 813-968-7282
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Provider Business Mailing Address
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Address Line | PO BOX 10744
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City | CLEARWATER
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State | FL
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Zip | 33757-8744
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Country | US
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Telephone | 727-532-0002
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Fax | 727-266-4828
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME35357
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License Number State | FL
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