Individual
AXEL COLLAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18861 NW 86TH CT APT 3901, HIALEAH, FL 33015-7231
(954) 235-0463
Mailing address
18861 NW 86TH CT APT 3901, HIALEAH, FL 33015-7231
(954) 235-0463
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11000641
FL
363LP2300X
Primary Care Nurse Practitioner
APRN11000641
FL
Other
Enumeration date
12/27/2018
Last updated
02/29/2020
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