Provider Demographics
NPI:1467406280
Name:DIAZ DELGADO, FELIPE (M D)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:
Last Name:DIAZ DELGADO
Suffix:
Gender:M
Credentials:M D
Other - Prefix:DR
Other - First Name:FELIPE
Other - Middle Name:
Other - Last Name:DIAZ DELGADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-0476
Mailing Address - Country:US
Mailing Address - Phone:787-432-2604
Mailing Address - Fax:787-824-7242
Practice Address - Street 1:52 BALDORIOTY
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-432-2604
Practice Address - Fax:787-824-7242
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77473Medicare UPIN
PR002-6917Medicare PIN