MEDICARE: DR. BENEDICTO COLON-PEREZ 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	208800000X	Urology Physician	8385	PR

General Provider Information

NPI Number	:	1154326395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENEDICTO COLON-PEREZ MD

Provider Business Mailing Address
First Line	:	PO BOX 789
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-0789
Country	:	US
Telephone Number	:	787-622-0700
Fax Number	:	787-622-0705

Provider Business Practice Location Address
First Line	:	1845 CARR 2
Second Line	:	STE 602
City	:	BAYAMON
State	:	PR
Zip	:	00959-7204
Country	:	US
Telephone Number	:	787-622-0700
Fax Number	:	787-622-0705

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	06/09/2023

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