Individual
MRS. LISA DOREEN COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 N ORANGE ST, NEW SMYRNA BEACH, FL 32168-6733
(386) 416-1040
(386) 416-1037
Mailing address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(386) 416-1023
(386) 416-1037
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/07/2007
Last updated
07/09/2007
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