Organization
MARISOL COLLAZO ORTIZ INC
Active
Other names
DBA Laboratorio Clinico Centro Medicina Especializada
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARISOL COLLAZO MD MT (LAB DIRECTOR)
(787) 739-5525
Entity
Organization
Contact information
Practice address
12 CALLE BARCELO, CIDRA, PR 00739-3446
(787) 739-5525
(787) 739-2054
Mailing address
12 CALLE BARCELO, CIDRA, PR 00739-3446
(787) 739-5525
(787) 739-2054
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
807
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0877
INTERNATIONAL MEDICAL CAR
—
01
—
15843
AMPR
—
01
—
20213
PREFERRED MEDICARE CHOICE
—
01
—
20463
AMERICAN HEALTH
—
01
—
30778
TRIPLE S
—
01
—
400123
PREFERRED HEALTH UTI
—
01
—
51539
LACRUZ AZUL DE PUERTO RIC
—
01
—
6390009
HUMANA HEALTH PLAN
—
01
—
LB00746
UIA
—
Enumeration date
01/29/2007
Last updated
12/21/2012
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