Sergio Collazo, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN1172 Issued in FL

Practice address

2931 W Hillsborough Ave
Tampa, FL 33614-6054

Phone

(813) 930-0930

Fax

(813) 930-0950

NPI assigned

May 1, 2019

Last updated

Aug 13, 2019By the provider in NPPES

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 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

Specialty

General Practice

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jose R Mole MD PAGroup PAC ID 8022014331, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lifespring Home Care of Tampa Home health agency, Tampa, FL, CCN 108219

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jose R Mole MD PA

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1881786127
  Medicare reassignment Care Compare group NPD
• Aarna Hospitality LLC

  dba Vistara Pharmacy

  • Community/Retail Pharmacy
  • Tampa, FL
  • NPI 1326422189
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• JD Jordan Enterprises, Inc.

  dba LifeSpring Home Care of Tampa

  • Home Health Agency
  • Tampa, FL
  • NPI 1881623056
  Care Compare affiliation

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1619531027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146054",
            "telephone_number": "813-930-0930",
            "fax_number": "813-930-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146054",
            "telephone_number": "813-930-0930",
            "fax_number": "813-930-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Ave Ponce De Leon",
            "address_purpose": "LOCATION",
            "city": "Hato Rey",
            "state": "PR",
            "postal_code": "009175032",
            "country_code": "US",
            "telephone_number": "787-758-2000 x3216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "SERGIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Gregory Collard, LMSW
• Karla Collazo Melian, MD
• Katherine Collazo Morales
• Antonio Collazo, L.M.T
• Jennifer Collazo
• Alina Ann Colleary
• College Hill Pharmacy
• Zackary Coller
• Jessica Nicole Collera, MSN, APRN, AGPCNP
• Danny Wayne Colley Jr.

• General Practice Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.
• 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.