MEDICARE: DR. LINDA INES COLLAZO-BATISTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D0062940	MD
2	208000000X	Pediatrics Physician	2006-01066	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104921659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA INES COLLAZO-BATISTA MD

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 TIMBER DR
Second Line	:
City	:	GARNER
State	:	NC
Zip	:	27529-4850
Country	:	US
Telephone Number	:	984-215-4560
Fax Number	:	984-215-4561

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	05/06/2021

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