Provider Demographics
NPI:1730919903
Name:COLON NEGRON, EDWIN ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:ANTONIO
Last Name:COLON NEGRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROAD 14 KM 72.2
Mailing Address - Street 2:BO RINCON SECTOR LOMAS
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-2800
Mailing Address - Country:US
Mailing Address - Phone:787-535-1001
Mailing Address - Fax:
Practice Address - Street 1:ROAD 14 KM 72.2
Practice Address - Street 2:BO RINCON SECTOR LOMAS
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737-2800
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24024208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice