Provider Demographics
NPI:1417770942
Name:COLON CANCER CARE LLC
Entity type:Organization
Organization Name:COLON CANCER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:COLON DONATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-607-1502
Mailing Address - Street 1:36 CALLE VEREDA URB MONTE VERDE REAL
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5984
Mailing Address - Country:US
Mailing Address - Phone:787-607-1502
Mailing Address - Fax:
Practice Address - Street 1:405 CALLE GERMAN MOYER
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2679
Practice Address - Country:US
Practice Address - Phone:787-607-1502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty