Provider Demographics
NPI:1104144070
Name:COLON, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:COLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 536881
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32853-6881
Mailing Address - Country:US
Mailing Address - Phone:407-982-7743
Mailing Address - Fax:407-914-2116
Practice Address - Street 1:2115 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6006
Practice Address - Country:US
Practice Address - Phone:407-982-7743
Practice Address - Fax:407-914-2116
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy