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General NPI Number Information
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NPI Number | 1396435053
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Entity Type | Individual
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Provider Name | JOSUE ELIEZER COLLAZO-LOPEZ MD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | HOSPITAL PEDIATRICO UNIVERSITARIO, CARR. 22 BO. MONACILLOS, CENTRO MEDICO
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City | RIO PIEDRAS
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State | PR
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Zip | 00935
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Country | US
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Telephone | 787-474-0333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 365067
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City | SAN JUAN
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State | PR
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Zip | 00936-5067
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Country | US
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Telephone | 787-474-0333
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 17503-I
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License Number State | PR
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