Individual provider Active NPI

Juan Ramon Santiago Colon, MD

  • Family Medicine Physician
  • Lakeland, FL
National Provider Identifier
1164628236
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ACN1727 Issued in FL
Practice address
5615 S Florida Ave Ste 111
Lakeland, FL 33813-2714
Phone
(863) 327-0132
Fax
(863) 777-2320
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15511 PR
Family Medicine Physician 207Q00000X ACN1727 FL Primary

Addresses

Primary practice location

5615 S Florida Ave Ste 111
Lakeland, FL 33813-2714

Mailing address

6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333

Other identifiers 2

IdentifierTypeStateIssuer
15511OtherPRMEDICAL LICENCE
ACN1727OtherFLFLORIDA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724002756 FL Practitioner - Family Practice 5597853127 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Group of Lakeland, LLC Family Medicine CurrentSince Jul 22, 2025 Accepting new patients

Locations

5615 S Florida Ave
Ste 111
Lakeland, FL 33813
Phone (863) 327-0132

6100 Blue Lagoon Dr
Ste 365
Miami, FL 33126
Phone (786) 322-7333

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1164628236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 S FLORIDA AVE STE 111",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132714",
            "telephone_number": "863-327-0132",
            "fax_number": "863-777-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO COLON",
        "first_name": "JUAN",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "15511",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN1727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE",
            "identifier": "15511",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "ACN1727",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.