Juan C Collazos-Rodriguez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME131002 Issued in FL

Practice address

1410 Royal Palm Beach Blvd
Royal Palm Beach, FL 33411-1608

Phone

(561) 777-5246

Fax

(561) 484-5752

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032

  Pediatrics

  Medicare reassignment NPD
• My Way Pediatrics LLC

  • Pediatrics Physician
  • Royal Palm Beach, FL
  • NPI 1336722982
  NPD Authorized official
• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1215199294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4695 MANDERLY DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334497406",
            "telephone_number": "702-756-9994",
            "fax_number": "561-484-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 ROYAL PALM BEACH BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111608",
            "telephone_number": "561-777-5246",
            "fax_number": "561-484-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZOS-RODRIGUEZ",
        "first_name": "JUAN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME131002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215199294",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Classone Medical Corp
• Nyoka Clemetson Blake, ARNP
• CMM Cardio Pulmonary Care Services
• Erika Paige Cohane, LCSW
• Kimberly Colin
• Joann Collegio, RRT
• Martyn Colman
• Maricel Colon-Santiago, MD
• Comfortable Care Dental Health Professionals, P.a.
• Comfortable Care Dental Health Professionals, P.a.

• Pediatrics Physician in Royal Palm Beach, FL
• Providers in Royal Palm Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.