Provider Demographics
NPI:1104593979
Name:COLON TORRES, KELVIN JOSE (MS, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:KELVIN
Middle Name:JOSE
Last Name:COLON TORRES
Suffix:
Gender:M
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:3902 CARROLLWOOD PLACE CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-3062
Mailing Address - Country:US
Mailing Address - Phone:787-204-4140
Mailing Address - Fax:
Practice Address - Street 1:1344 W FLETCHER AVE STE 104
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3366
Practice Address - Country:US
Practice Address - Phone:813-961-1666
Practice Address - Fax:813-961-1107
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2022-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLSA20800235Z00000X
FLSZ10409235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist