Provider Demographics
NPI:1568456200
Name:COLON FERREIRA, LUIS ROBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ROBERTO
Last Name:COLON FERREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:V3 CALLE MONTE DEL ESTADO
Mailing Address - Street 2:COLINAS METROPOLITANAS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5236
Mailing Address - Country:US
Mailing Address - Phone:787-790-8846
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:174 CALLE LUIS BARRERAS S
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4615
Practice Address - Country:US
Practice Address - Phone:787-263-0966
Practice Address - Fax:787-848-0318
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR08969207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0081525Medicare ID - Type Unspecified