MEDICARE: DR. VICTOR J COLON-VAZQUEZ M.D.

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	207RG0100X	Gastroenterology Physician	13117	PR

General Provider Information

NPI Number	:	1598768061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR J COLON-VAZQUEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7947
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-7947
Country	:	US
Telephone Number	:	787-747-2530
Fax Number	:	787-747-2530

Provider Business Practice Location Address
First Line	:	TORRE HOSPITAL HIMA SUITE 122
Second Line	:	AVE LUIS MUNOZ RIVERA
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-747-2530
Fax Number	:	787-747-2530

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/31/2007

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