Provider Demographics
NPI:1083162580
Name:MURILLO DELGADO, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:
First Name:JUAN CARLOS
Middle Name:
Last Name:MURILLO DELGADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SW 87TH AVE # C340
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-0109
Mailing Address - Fax:305-595-7092
Practice Address - Street 1:600 NE 22ND TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-4707
Practice Address - Country:US
Practice Address - Phone:786-601-2502
Practice Address - Fax:786-377-3178
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55768207R00000X
FLME133199207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine