1699791764 NPI number — DR. JOSE ALBERTO DELGADO MD

Table of content: DR. JOSE ALBERTO DELGADO MD (NPI 1699791764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699791764 NPI number — DR. JOSE ALBERTO DELGADO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELGADO
Provider First Name:
JOSE
Provider Middle Name:
ALBERTO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699791764
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 42
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANATI
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00674-0042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-621-3700
Provider Business Mailing Address Fax Number:
787-621-3710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. # 2 INT. 668
Provider Second Line Business Practice Location Address:
URB. ATENAS CALLE HERNANDEZ CARRION
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-621-3700
Provider Business Practice Location Address Fax Number:
787-621-3710
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  6398 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2-6398 . This is a "CIGNA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 067191 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1112465 . This is a "HUMANA GOBIERNO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: N405 . This is a "INTN'L MEDICAL CARD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1112465 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9790020 . This is a "HUMANA PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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