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General NPI Number Information
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NPI Number | 1568002921
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Entity Type | Individual
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Provider Name | JESSICA HELEN COLLADO
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Gender | Female
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1000 NW 9TH CT
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City | BOCA RATON
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State | FL
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Zip | 33486-2268
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Country | US
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Telephone | 561-395-5204
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Fax | 561-395-6177
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Provider Business Mailing Address
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Address Line | 2766 CARAMBOLA CIR S
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City | COCONUT CREEK
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State | FL
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Zip | 33066-2300
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Country | US
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Telephone | 786-318-4917
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11005636
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License Number State | FL
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