Provider Demographics
NPI:1699152140
Name:COLON RIVERA, XAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:XAVIER
Middle Name:
Last Name:COLON RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LA ALBORADA
Mailing Address - Street 2:1225 CARR 2 APTO 3431
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7301
Mailing Address - Country:US
Mailing Address - Phone:939-262-8260
Mailing Address - Fax:
Practice Address - Street 1:WINNER'S MALL BUILDING, LOCAL E
Practice Address - Street 2:CALAZAN LASALLE STREET
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:939-262-8260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine