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General NPI Number Information
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NPI Number | 1053399931
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Entity Type | Individual
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Provider Name | HYDEE L COLLAZO SANTIAGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/02/2006
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 207 CALLE MORSE HOSPITAL LAFAYETTE
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City | ARROYO
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State | PR
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Zip | 00714-2350
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Country | US
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Telephone | 787-864-3494
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Fax | 787-864-3494
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Provider Business Mailing Address
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Address Line | PO BOX 691
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City | PATILLAS
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State | PR
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Zip | 00723-0691
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Country | US
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Telephone | 787-315-5957
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Fax | 787-839-8900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 14339
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License Number State | PR
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