Individual
MR. J. RAFAEL COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
120 NW 28TH ST, GAINESVILLE, FL 32607-2511
(352) 246-5384
(352) 376-0126
Mailing address
7554 SW 84TH DR, GAINESVILLE, FL 32608-8489
(352) 871-1440
(352) 376-0126
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT11408
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
03/09/2007
Last updated
07/09/2007
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