Provider Demographics
NPI:1225523731
Name:LANFRANCO DELGADO, ELYN ELIEZER (MD)
Entity Type:Individual
Prefix:
First Name:ELYN
Middle Name:ELIEZER
Last Name:LANFRANCO 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 1:6037 KIMBERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2811
Mailing Address - Country:US
Mailing Address - Phone:954-379-8994
Mailing Address - Fax:954-289-4682
Practice Address - Street 1:6037 KIMBERLY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2811
Practice Address - Country:US
Practice Address - Phone:954-379-8994
Practice Address - Fax:954-289-4682
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14712207Q00000X
FLME158264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC854409Medicaid
SCSCK5046067OtherMEDICARE PIN
SCSCK504J577OtherMEDICARE PIN
SCSCK5046084OtherMEDICARE PIN