1770771149 NPI number — MR. DELGADO FRANCISCO BENOZA PHYSICAL THERAPIST

Table of content: MR. DELGADO FRANCISCO BENOZA PHYSICAL THERAPIST (NPI 1770771149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770771149 NPI number — MR. DELGADO FRANCISCO BENOZA PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENOZA
Provider First Name:
DELGADO
Provider Middle Name:
FRANCISCO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
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:
1770771149
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 635073
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-820-6521
Provider Business Mailing Address Fax Number:
513-742-0943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 S MAIN ST STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLE GLADE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33430-4910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-996-8086
Provider Business Practice Location Address Fax Number:
561-996-2905
Provider Enumeration Date:
10/10/2007

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: 225100000X , with the licence number:  PT16986 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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