Healthcare Provider Details

I. General information

NPI: 1750766960
Provider Name (Legal Business Name): CRISTINA M BIRD COLLADO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 365067
SAN JUAN PR
00936-5067
US

IV. Provider business mailing address

230 AVE ARTERIAL HOSTOS APT 405E
SAN JUAN PR
00918-1472
US

V. Phone/Fax

Practice location:
  • Phone: 787-756-4010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19703
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number279581
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number19703
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: