Provider Demographics
NPI:1063671212
Name:PALAU COLLAZO, MILADYS MIRIAM (MD)
Entity Type:Individual
Prefix:
First Name:MILADYS
Middle Name:MIRIAM
Last Name:PALAU COLLAZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MILADYS
Other - Middle Name:M
Other - Last Name:PALAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9401 SW DISCOVERY WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2381
Mailing Address - Country:US
Mailing Address - Phone:772-834-7362
Mailing Address - Fax:772-618-2024
Practice Address - Street 1:9401 SW DISCOVERY WAY STE 102
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2381
Practice Address - Country:US
Practice Address - Phone:772-834-7362
Practice Address - Fax:772-618-2024
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1174252080P0205X, 208000000X, 282NC2000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No282NC2000XHospitalsGeneral Acute Care HospitalChildren