Provider Demographics
NPI:1245230127
Name:DELCHARCO, MANUEL F (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:F
Last Name:DELCHARCO
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 1:2801 SE 1ST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0409
Mailing Address - Country:US
Mailing Address - Phone:352-690-6300
Mailing Address - Fax:352-690-6802
Practice Address - Street 1:2801 SE 1ST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0409
Practice Address - Country:US
Practice Address - Phone:352-690-6300
Practice Address - Fax:352-690-6802
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64539207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31734OtherBCBSFL
FL379788100Medicaid
FL31734ZMedicare ID - Type Unspecified
FLG27976Medicare UPIN