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General NPI Number Information
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NPI Number | 1326075060
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Entity Type | Individual
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Provider Name | PEDRO COLLAZO MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 70 CALLE SANTA CRUZ URB. SANTA CRUZ
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City | BAYAMON
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State | PR
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Zip | 00961-7020
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Country | US
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Telephone | 787-620-4747
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Fax |
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Provider Business Mailing Address
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Address Line | 667 AVE PONCE DE LEON
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City | SAN JUAN
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State | PR
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Zip | 00907-3201
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Country | US
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Telephone | 787-620-4747
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 011828
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License Number State | PR
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