Irma Leticia Collazo, X-RAY TECH

Individual provider Active NPI Radiologic Technologist · Patillas, PR

NPI 1902010226 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1902010226
Entity type
Individual (NPI type 1)
Primary specialty
Radiologic Technologist 247100000X
License
001184 (PR)
Practice address
99 Guillermo Riefkhol Street
Patillas, PR 00723-0697
Phone
(787) 839-4320
Fax
(787) 271-0004
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001184PRMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Servicios Primarios de Salud de Patillas Inc. Past Accepting new patients
Centro Servicios Primarios de Salud de Patillas Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 001184 PR Yes

Addresses

Primary practice location

99 Guillermo Riefkhol Street
Patillas, PR 00723-0697

Mailing address

99 Guillermo Riefkhol Street
Patillas, PR 00723-0697
Phone (787) 839-4320

Other identifiers

IdentifierTypeStateIssuer
001184OtherPRRADIOLOGY TECH LICENSE

Other providers in Patillas, PR

All providers in Patillas, PR · Radiologic Technologist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.