Collazo, Lucas R
Collazo, Lucas R is an individual health care provider with primary practice located at 2921 Telestar Ct Suite 140, Falls Church VA 22042-1205. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Collazo, Lucas R can be contacted via phone (703) 280-5858.Contact Information
Primary practice address
2921 Telestar Ct Suite 140
Falls Church VA 22042-1205
Phone: (703) 280-5858
Fax: (703) 280-2654
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 0101222198 | Virginia |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 0101222198 | Virginia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101222198 | Virginia |
Profile Details
| NPI number | 1205805603 |
|---|---|
| LBN Legal business name | Collazo, Lucas R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 16th, 2006 |
| Last updated | Dec 6th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205805603 | NPPES |
| Virginia | MEDICAID | 7310471 | |
| Virginia | MEDICAID | 033741600 | |
| Virginia | MEDICAID | 758903400 |
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