Individual provider Active NPI

Daisy Rodriguez Collazo

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1710595681
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007992 Issued in FL
Practice address
3108 W Giddens Ave
Tampa, FL 33614-6719
Phone
(813) 499-4939
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11007992 FL
Family Nurse Practitioner 363LF0000X 11007992 FL Primary

Addresses

Primary practice location

3108 W Giddens Ave
Tampa, FL 33614-6719

Mailing address

3108 W Giddens Ave
Tampa, FL 33614-6719
Phone (813) 499-4939

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101001627 FL Practitioner - Nurse Practitioner 0042687261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Pain Relief Group PLLCGroup PAC ID 4688960271, 80 clinicians

Practice addresses (Care Compare)

10903 Sheldon Rd
Tampa, FL 33626-4702
Phone (813) 682-0345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11007992FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles K Friedman DO PA CurrentSince Apr 7, 2023 Accepting new patients
Florida Pain Relief Group PLLC Family CurrentSince Jul 16, 2022 Accepting new patients

Locations

10301 Hagen Ranch Rd
Ste B270
Boynton Beach, FL 33437
Phone (561) 853-1001

1320 S Belcher Rd
Clearwater, FL 33764
Phone (727) 518-8660

5767 49th St N
St Petersburg, FL 33709
Phone (727) 350-0450

10903 Sheldon Rd
Tampa, FL 33626
Phone (727) 631-7846

3450 E Fletcher Ave
Ste 350
Tampa, FL 33613
Phone (813) 739-7493

7518 Cypress Gardens Blvd
Winter Haven, FL 33884
Phone (813) 426-8263

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1710595681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 W GIDDENS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146719",
            "telephone_number": "813-499-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 W GIDDENS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146719",
            "telephone_number": "813-499-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ COLLAZO",
        "first_name": "DAISY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11007992",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.