Provider Demographics
NPI:1316994445
Name:COLON, REBECCA LEA (DO)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LEA
Last Name:COLON
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Gender:F
Credentials:DO
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Mailing Address - Street 1:6405 N FEDERAL HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1412
Mailing Address - Country:US
Mailing Address - Phone:954-772-2411
Mailing Address - Fax:954-772-3766
Practice Address - Street 1:6405 N FEDERAL HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1412
Practice Address - Country:US
Practice Address - Phone:954-772-2411
Practice Address - Fax:954-772-3766
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2013-07-11
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Provider Licenses
StateLicense IDTaxonomies
FLOS9426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS9426OtherFLORIDA MEDICAL LICENSE