Active NPI
Monica Isabel Collazos Perez
- Dentist
- Tallahassee, FL
National Provider Identifier
1871146829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24465
- Practice address
- 1329 E Tennessee St
Tallahassee, FL 32308-5107 - Phone
- (850) 878-7999
- NPI assigned
- Jul 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 24465 | FL | Primary |
Addresses
Primary practice location
1329 E Tennessee St
Tallahassee, FL 32308-5107
Mailing address
358 Persimmon Rd
Sopchoppy, FL 32358-0859
Phone (407) 780-0575
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190830001514 | FL | Order and Referring Only - Dentist | 7911235809 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24465 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1871146829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "358 PERSIMMON RD",
"city": "SOPCHOPPY",
"state": "FL",
"postal_code": "323580859",
"telephone_number": "407-780-0575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 E TENNESSEE ST",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323085107",
"telephone_number": "850-878-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZOS PEREZ",
"first_name": "MONICA",
"middle_name": "ISABEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "24465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.