Ernesto L Collazo Batista MD PSC

Organization Active NPI Ophthalmology Physician · Santurce, PR

NPI 1376686782 · NPPES record last updated Sep 8, 2010

Key facts

NPI
1376686782
Entity type
Organization (NPI type 2)
Primary specialty
Ophthalmology Physician 207W00000X
Legal business name
ERNESTO L COLLAZO BATISTA MD PSC
Practice address
1503 Calle Prof Augusto Rodrigue
Segundo Piso
Santurce, PR 00909-2275
Phone
(787) 728-3700
Fax
(787) 728-4390
NPI assigned
Feb 15, 2007
Organization subpart
No

Authorized official

Name
Dr. Ernesto Luis Collazo, M.D.
Title
President
Phone
(787) 728-3700

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110624000214 PR Part B Supplier - Clinic/Group Practice 2961609490 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

Locations

1503 Calle Prof Augusto Rodriguez
Fl 2
San Juan, PR 00909
Phone (787) 728-3700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207W00000X Yes
Eyewear Supplier 332H00000X

Addresses

Primary practice location

1503 Calle Prof Augusto Rodrigue
Segundo Piso
Santurce, PR 00909-2275

Mailing address

PO Box 366407
San Juan, PR 00936-6407
Phone (787) 728-3700

Other identifiers

IdentifierTypeStateIssuer
6133980002OtherPRPTAN

Other providers in Santurce, PR

All providers in Santurce, PR · Ophthalmology Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.