Individual
DR. LUIS C COLLAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
8601 NW 58TH ST, DORAL, FL 33166-3311
(305) 513-4116
Mailing address
8500 SW 109TH AVE APT 212, MIAMI, FL 33173-4458
(786) 261-1163
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20855
FL
Other
Enumeration date
08/05/2014
Last updated
08/06/2014
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