Individual provider Active NPI

Odalis Michelle Vazquez Colon

  • Chiropractor
  • Hollywood, FL
National Provider Identifier
1083346845
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14110 Issued in FL
Practice address
3900 Hollywood Blvd Ste 204
Hollywood, FL 33021-6797
Phone
(954) 866-9693
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14110 FL Primary

Addresses

Primary practice location

3900 Hollywood Blvd Ste 204
Hollywood, FL 33021-6797

Mailing address

4971 Le Chalet Blvd Ste 100
Boynton Beach, FL 33436-1418
Phone (561) 733-5590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1083346845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 LE CHALET BLVD STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334361418",
            "telephone_number": "561-733-5590",
            "fax_number": "561-740-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 HOLLYWOOD BLVD STE 204",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216797",
            "telephone_number": "954-866-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ COLON",
        "first_name": "ODALIS",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.