Provider Demographics
NPI:1013184092
Name:SILVAGNOLI -COLLAZO, NORMA IRIS (MT)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:IRIS
Last Name:SILVAGNOLI -COLLAZO
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CALLE BARCELO
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-2205
Mailing Address - Country:US
Mailing Address - Phone:787-847-0150
Mailing Address - Fax:787-847-0150
Practice Address - Street 1:59 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-2205
Practice Address - Country:US
Practice Address - Phone:787-847-0150
Practice Address - Fax:787-847-0150
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1106246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038355Medicare PIN