Collazo Castro Dermatology Clinics PSC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

15836 Issued in PR

Legal business name

COLLAZO CASTRO DERMATOLOGY CLINICS PSC

Practice address

C&C Professional Building Suite #4
Carr. #2, Urb.Flamboyan, Marginal B-9
Manati, PR 00674

Phone

(787) 884-4400

Fax

(787) 884-8800

NPI assigned

Mar 13, 2008

Last updated

Mar 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Collazo Castro, M.D.NPI 1669666137

Title

President

Phone

(787) 884-4400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Collazo Castro

  • Dermatology Physician
  • Manati, PR
  • NPI 1669666137
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1366613796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SABANERA DORADO 91",
            "address_2": "CAMINO DE LOS COHITRES",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-884-4400",
            "fax_number": "787-884-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C&C PROFESSIONAL BUILDING SUITE #4",
            "address_2": "CARR. #2, URB.FLAMBOYAN, MARGINAL B-9",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-884-4400",
            "fax_number": "787-884-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLAZO CASTRO DERMATOLOGY CLINICS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "COLLAZO CASTRO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-884-4400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PR",
            "license": "15836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinica Terapia Fisica Manati
• Clinical Laboratory Services of Manati, Inc (Laboratorio Clinico Manati II)
• Clinical Laboratory Services of Manati, Inc (Laboratorio Clinico Manati)
• Cohesion Health Services
• Xavier Alexis Collado-Mendez, MD
• Michelle Collazo Castro
• Naomi Collazo Gutierrez, MD
• Ronald Collazo Pagan, M.D.
• Carlos Arturo Colon - Guzman, MD
• Shirley Ann Colon Martinez, MSW

• Dermatology Physician in Manati, PR
• Providers in Manati, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.