Individual
ROBERTO G. COLON-MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 581-2121
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
13312643-1205
UT
207X00000X
Orthopaedic Surgery Physician
23134
PR
208D00000X
General Practice Physician
14450
PR
Other
Enumeration date
05/20/2016
Last updated
03/15/2024
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