Jesus Johan Collazo

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1875 Issued in PR

Practice address

Calle Santa Cruz,Building#73 Floor#2 Office 208
Bayamon, PR 00961

Phone

(787) 995-7884

NPI assigned

Feb 22, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1932855665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 7283",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007679521",
            "telephone_number": "787-365-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SANTA CRUZ,BUILDING#73 FLOOR#2 OFFICE 208",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-995-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "JESUS",
        "middle_name": "JOHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PR",
            "license": "1875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pedro Nelson Colberg, MD
• Angel L. Collazo Bonilla, M.D.
• Roseanne Collazo Nieves
• Adriana Collazo Ortiz, MD
• Stephany Collazo Otero
• Jose Vicente Collazo
• Pedro Collazo, MD
• Sheyla Marie Collazo, M.D.
• Joanna Liz Colon Collazo, MA, PSIC
• Keimarisse Colon Diaz, PHD

• Physical Therapy Assistant in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Physical Therapy Assistant in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.