Provider Demographics
NPI:1134103690
Name:DELGADO, MARTA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
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:#65 JOSE C. BARBOSA
Mailing Address - Street 2:SUITE# 107
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-878-6791
Mailing Address - Fax:787-878-5599
Practice Address - Street 1:65 AVE BARBOSA
Practice Address - Street 2:SUITE 107
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2799
Practice Address - Country:US
Practice Address - Phone:787-878-6791
Practice Address - Fax:787-878-6791
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8292207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G 07100Medicare UPIN