Provider Demographics
NPI:1508129925
Name:NOEL E DELGADILLO, MD, P.A.
Entity Type:Organization
Organization Name:NOEL E DELGADILLO, MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:DELGADILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:305-598-7001
Mailing Address - Street 1:8700 N. KENDALL DRIVE, SUITE 218
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2206
Mailing Address - Country:US
Mailing Address - Phone:305-598-7001
Mailing Address - Fax:305-598-7032
Practice Address - Street 1:8700 N. KENDALL DRIVE, SUITE 218
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2206
Practice Address - Country:US
Practice Address - Phone:305-598-7001
Practice Address - Fax:305-598-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-00697082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251942900Medicaid
FL28389AMedicare PIN
FLG44066Medicare UPIN