Provider Demographics
NPI:1649857103
Name:COLLAZO OCASIO, KARIMAR
Entity type:Individual
Prefix:
First Name:KARIMAR
Middle Name:
Last Name:COLLAZO OCASIO
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 1:126 PARCELAS BARAHONA
Mailing Address - Street 2:CALLE ANDRES NARVAEZ
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687
Mailing Address - Country:US
Mailing Address - Phone:787-363-8019
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO COMERCIAL LOCAL 1
Practice Address - Street 2:URB. CATALANA #66
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-915-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR74752355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6722580OtherDRIVERS LICENSE