Provider Demographics
NPI:1972244507
Name:COLLAZO MEDICAL SERVICE CORP
Entity Type:Organization
Organization Name:COLLAZO MEDICAL SERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / EMT-P
Authorized Official - Prefix:
Authorized Official - First Name:RAMSY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLAZO LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-452-4908
Mailing Address - Street 1:URB. STARLIGHT
Mailing Address - Street 2:CALLE PERSEO 3113
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:939-438-7943
Mailing Address - Fax:787-842-4328
Practice Address - Street 1:URB. STARLIGHT
Practice Address - Street 2:CALLE PERSEO 3113
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:939-438-7943
Practice Address - Fax:787-842-4328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR479117OtherPR INCORPORATION NUMBER