Provider Demographics
NPI:1275059305
Name:DELGADO HEVIA, PATRICIA LAZARA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LAZARA
Last Name:DELGADO HEVIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12370 SW 212TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5901
Mailing Address - Country:US
Mailing Address - Phone:305-726-6124
Mailing Address - Fax:786-206-4702
Practice Address - Street 1:14225 SW 156TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1037
Practice Address - Country:US
Practice Address - Phone:305-726-6124
Practice Address - Fax:786-206-4702
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst