Provider Demographics
NPI:1871393926
Name:COLON LOPEZ, PABLO WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:WILLIAM
Last Name:COLON LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PABLO
Other - Middle Name:WILLIAM
Other - Last Name:COLON LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:CALLE DR. SANTIAGO VEVE #123
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4266
Mailing Address - Country:US
Mailing Address - Phone:787-892-0090
Mailing Address - Fax:787-264-7908
Practice Address - Street 1:BARRIO CAIN ALTO ROUTE 2 KM 173.4
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4266
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:787-264-7908
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program