Organization
HEART AND SOUL PEDIATRICS LLC
Active
Other names
Heart and Soul Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENID COLON MD (PCP)
(770) 345-0055
Entity
Organization
Contact information
Practice address
205 WALESKA RD STE 1C, CANTON, GA 30114-2493
(470) 371-3271
(770) 345-0020
Mailing address
11770 HAYNES BRIDGE RD, SUITE 205 PMB 307, ALPHARETTA, GA 30009-1968
(470) 371-3271
(770) 345-0020
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275165292
NPI ORGANIZATION
GA
01
—
1306836747
NPI
GA
01
—
43020
LICENSE
GA
Enumeration date
02/07/2020
Last updated
03/07/2023
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