Individual provider Active NPI

Miladys Miriam Palau Collazo, MD

  • Pediatric Endocrinology Physician
  • Port St Lucie, FL
National Provider Identifier
1063671212
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME117425 Issued in FL
Practice address
9401 SW Discovery Way Ste 102
Port St Lucie, FL 34987-2381
Phone
(772) 834-7362
Fax
(772) 618-2024
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X ME117425 FL Primary
Pediatrics Physician 208000000X ME117425 FL

Addresses

Primary practice location

9401 SW Discovery Way Ste 102
Port St Lucie, FL 34987-2381

Mailing address

9401 SW Discovery Way Ste 102
Port Saint Lucie, FL 34987-2381
Phone (772) 834-7362

Other names 1

  • Miladys M Palau Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327003761 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric MedicinePractitioner - Endocrinology 1355864521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Endocrine and Metabolic Center of Florida, PLLC Pediatrics CurrentSince Jul 25, 2021 Accepting new patients
Vitalmd Group Holding LLC Pediatrics PastSince Oct 1, 2020 Accepting new patients

Locations

9401 SW Discovery Way
Ste 102
Port St Lucie, FL 34987
Phone (772) 834-7362

Interoperability endpoints

  • Direct secure messaging: mcollazo19561@jupitermedicalcenter.direct-ci.com
  • Direct secure messaging: miladys.palaucollazo@toplinemd.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1063671212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-834-7362",
            "fax_number": "772-618-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-834-7362",
            "fax_number": "772-618-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAU COLLAZO",
        "first_name": "MILADYS",
        "middle_name": "MIRIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME117425",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME117425",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILADYS",
            "last_name": "PALAU",
            "middle_name": "M",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.