Collazo Medical Service Corp

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COLLAZO MEDICAL SERVICE CORP

Practice address

Urb. Starlight
Calle Perseo 3113
Ponce, PR 00717

Phone

(939) 438-7943

Fax

(787) 842-4328

NPI assigned

Apr 6, 2022

Organization subpart

No

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

Authorized official

Name

Ramsy Collazo Lugo

Title

President / Emt-P

Phone

(939) 452-4908

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1972244507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. STARLIGHT",
            "address_2": "CALLE PERSEO 3113",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "939-438-7943",
            "fax_number": "787-842-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. STARLIGHT",
            "address_2": "CALLE PERSEO 3113",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "939-438-7943",
            "fax_number": "787-842-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLAZO MEDICAL SERVICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-05",
        "status": "A",
        "authorized_official_last_name": "COLLAZO LUGO",
        "authorized_official_first_name": "RAMSY",
        "authorized_official_title_or_position": "PRESIDENT / EMT-P",
        "authorized_official_telephone_number": "939-452-4908"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR  INCORPORATION NUMBER",
            "identifier": "479117",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coalicion de Coaliciones Pro Personas Sin Hogar de Puerto Rico, Inc
• Joshua Ismael Collado Lugo
• Daniel Collado, M.D.
• Jose Luis Collazo Hernandez, LCSW
• Jose Antonio Collazo Llera, MD STUDENT
• Hector Omar Collazo Santiago, M.D.
• Bryan Jael Collazo-Rodriguez, PHD
• Maria Collazo-Suarez, MD
• Carmen I Collazo
• Margarita R Collazo, MD

• Land Ambulance in Ponce, PR
• Providers in Ponce, PR by specialty
• Land Ambulance in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.