Organization Active NPI

My Way Pediatrics LLC

  • Pediatrics Physician
  • Royal Palm Beach, FL
National Provider Identifier
1336722982
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MY WAY PEDIATRICS LLC
Practice address
1410 Royal Palm Beach Blvd
Royal Palm Beach, FL 33411-1608
Phone
(561) 777-5246
Fax
(561) 484-5752
NPI assigned
May 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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

Authorized official

Name
Juan C Collazos-Rodriguez, MDNPI 1215199294
Title
Pediatrician
Phone
(702) 756-9994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

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

Mailing address

4695 Manderly Dr
Wellington, FL 33449-7406
Phone (702) 756-9994

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2230537My Way Pediatrics Associates, LLC1410 Royal Palm Beach Blvd, Royal Palm Beach, FL 33411Certificate of waiverJul 25, 2027

National Provider Directory

National Provider Directory

Locations

1410 Royal Palm Beach Blvd
Royal Palm Beach, FL 33411
Phone (561) 423-9944

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619913600000",
    "number": "1336722982",
    "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"
        },
        {
            "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": {
        "organization_name": "MY WAY PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A",
        "authorized_official_last_name": "COLLAZOS-RODRIGUEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "702-756-9994",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • 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 Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.