Basic Information
| Provider Information | |||||||||
| NPI: | 1386294171 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELGADO | ||||||||
| FirstName: | RUBEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 ALTON RD | ||||||||
| Address2: | PATHOLOGY DEPARTMENT SUITE 2400 | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056742277 | ||||||||
| FaxNumber: | 3056742999 | ||||||||
| Practice Location | |||||||||
| Address1: | 4300 ALTON RD | ||||||||
| Address2: | PATHOLOGY DEPARTMENT SUITE 2400 | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056742277 | ||||||||
| FaxNumber: | 3056742999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2019 | ||||||||
| LastUpdateDate: | 09/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | TRN29725 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.