Provider Demographics
NPI:1225576580
Name:DELGADO, MARIA (ATO)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:ATO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611-0639
Mailing Address - Country:US
Mailing Address - Phone:939-256-0890
Mailing Address - Fax:
Practice Address - Street 1:CARR. 600 KM 6.9
Practice Address - Street 2:
Practice Address - City:ANGELES
Practice Address - State:PR
Practice Address - Zip Code:00611-0639
Practice Address - Country:US
Practice Address - Phone:939-256-0890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1976-1405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional