Daniel Colon – Clinical Medical Laboratory

Key facts

NPI: 1104144070
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Medical Laboratory 291U00000X
Practice address: 2115 E Jefferson St
Orlando, FL 32803-6006
Phone: (407) 982-7743
Fax: (407) 914-2116
NPI assigned: May 17, 2010
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Mobile Health Labs, LLC Clinical Medical Laboratory · Orlando, FL · NPI 1578876769

NPD (past) Authorized official CLINICAL MEDICAL LABORATORY

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Mobile Health Labs, LLC	Clinical Medical Laboratory	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Medical Laboratory	291U00000X			Yes
Phlebotomy Technician	246RP1900X

Addresses

Primary practice location

2115 E Jefferson St
Orlando, FL 32803-6006

Mailing address

PO Box 536881
Orlando, FL 32853-6881
Phone (407) 982-7743

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 16, 2010.

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1104144070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536881",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328536881",
            "telephone_number": "407-982-7743",
            "fax_number": "407-914-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 E JEFFERSON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328036006",
            "telephone_number": "407-982-7743",
            "fax_number": "407-914-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

All providers in Orlando, FL · Clinical Medical Laboratory in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.