Provider Demographics
NPI:1295858462
Name:GARCIA DELGADO, PEDRO IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:IVAN
Last Name:GARCIA 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:URB ATENAS CALLE HERNANDEZ CARRION E26 BZN 7
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-549-7066
Mailing Address - Fax:
Practice Address - Street 1:URB ATENAS CALLE HERNANDEZ CARRION E26
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-549-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR157103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR660606390OtherCOSVI
PR660606390OtherCIGNA
PR660606390OtherMCS
PR660606390OtherMAPFRE
PR84142OtherSSS
PR9161OtherIMC
PR9500314OtherCRUZ AZUL
PR2005101013181OtherPMC
PR2198OtherHUMANA
PR84142OtherAPS