Provider Demographics
NPI:1427157270
Name:COLON-GARCIA, PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:COLON-GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:COLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11215 METRO PKWY
Mailing Address - Street 2:BLDG 3 STE 100
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1206
Mailing Address - Country:US
Mailing Address - Phone:239-208-2212
Mailing Address - Fax:
Practice Address - Street 1:11215 METRO PKWY STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1206
Practice Address - Country:US
Practice Address - Phone:239-208-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTM007692084N0400X
MO20200042132084N0400X
PAMD4720642084N0400X
NY2969372084N0400X
OH35.1323372084N0400X
ND150602084N0400X
NH185632084N0400X
MS256932084N0400X
ORMD1858012084N0400X
LAMD2003052084N0400X
MI43011140732084N0400X
FLME1340652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07079094Medicaid
AL009913486Medicaid
NH3114322Medicaid
LAP00459836OtherRAILROAD MEDICARE
LA1214990Medicaid
LA4K483D867Medicare PIN
LA4K483Medicare PIN