Active NPI
Griselle Collazo, O.T.
- Physical Disabilities Residential Treatment Facility
- San Juan, PR
National Provider Identifier
1164707568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Disabilities Residential Treatment Facility
- License
- 1104
- Practice address
- Calle Mayaguez #214
San Juan, PR 00917 - Phone
- (787) 957-6327
- NPI assigned
- Oct 17, 2011
- Last updated
- Oct 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Disabilities Residential Treatment Facility | 320700000X | 1104 | PR | Primary |
Addresses
Primary practice location
Calle Mayaguez #214
San Juan, PR 00917
Mailing address
Col. Providencia Calle Las Rosas #29
P.O Box 987
Patillas, PUERTO RICO 00723
UM
Phone (787) 360-2493
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1104 | PR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1164707568",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "COL. PROVIDENCIA CALLE LAS ROSAS #29",
"address_2": "P.O BOX 987",
"city": "PATILLAS",
"state": "PUERTO RICO",
"postal_code": "00723",
"telephone_number": "787-360-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE MAYAGUEZ #214",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00917",
"telephone_number": "787-957-6327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZO",
"first_name": "GRISELLE",
"name_prefix": "Mrs.",
"credential": "O.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-17",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "PR",
"license": "1104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.