Basic Information
| Provider Information | |||||||||
| NPI: | 1578592051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELGADO | ||||||||
| FirstName: | DELIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10011 SEMINOLE BLVD | ||||||||
| Address2: | |||||||||
| City: | SEMINOLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337722539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273932800 | ||||||||
| FaxNumber: | 7273932801 | ||||||||
| Practice Location | |||||||||
| Address1: | 10011 SEMINOLE BLVD | ||||||||
| Address2: | |||||||||
| City: | SEMINOLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337722539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273932800 | ||||||||
| FaxNumber: | 7273932801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME68648 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 268772 | 01 | FL | AVMED | OTHER | 201789 | 01 | FL | AMERIGROUP | OTHER | 27327 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |