Provider Demographics
NPI:1033511886
Name:COLLAZO, MARITZA
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:COLLAZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 CALLE FLAMBOYAN
Mailing Address - Street 2:URBANIZACION SABANA DEL PALMAR
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782
Mailing Address - Country:US
Mailing Address - Phone:787-410-4840
Mailing Address - Fax:
Practice Address - Street 1:520 CALLE FLAMBOYAN
Practice Address - Street 2:URBANIZACION SABANA DEL PALMAR
Practice Address - City:COMERIO
Practice Address - State:PR
Practice Address - Zip Code:00782
Practice Address - Country:US
Practice Address - Phone:787-410-4840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator