MEDICARE: DR. IVAN COLON ALVARADO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	22154	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033513007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVAN COLON ALVARADO MD

Provider Business Mailing Address
First Line	:	2012 CALLE E DORS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6941
Country	:	US
Telephone Number	:	787-487-4699
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 CALLE SAN CLAUDIO STE 201
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4257
Country	:	US
Telephone Number	:	787-292-8700
Fax Number	:	787-292-8700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2014
Last Update Date	:	12/17/2024

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