Pedro Rafael Collazo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13488 Issued in PR

Practice address

2321 Calle Universidad
PH-1
Ponce, PR 00717

Phone

(787) 381-1086

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225179302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5216",
            "address_2": "ATOCHA STATION",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007335216",
            "telephone_number": "787-284-5514",
            "fax_number": "787-259-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 CALLE UNIVERSIDAD",
            "address_2": "PH-1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "787-381-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "PEDRO",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "13488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hector Omar Collazo Santiago, M.D.
• Bryan Jael Collazo-Rodriguez, PHD
• Maria Collazo-Suarez, MD
• Carmen I Collazo
• Margarita R Collazo, MD
• Sergio Collazo
• Violeta Collazo
• Santiago Rafael Colom Brana
• Adriana Maria Colom Diaz, MEDICAL STUDENT
• Gabriel Antonio Colon Alverio

• Family Medicine Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.