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General NPI Number Information
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NPI Number | 1821058199
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Entity Type | Individual
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Provider Name | CARLOS COLON-GOMEZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | EDIF PARRA 2225 PONCE BYPASS SUITE 807-808
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City | PONCE
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State | PR
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Zip | 00717-1322
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Country | US
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Telephone | 787-812-5811
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Fax |
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Provider Business Mailing Address
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Address Line | 609 AVE TITO CASTRO SUITE 102 PMB 365
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City | PONCE
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State | PR
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Zip | 00716-2232
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Country | US
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Telephone | 787-843-3661
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Fax | 787-843-3691
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 10176
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License Number State | PR
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