Provider Demographics
NPI:1548210180
Name:DELOS CLIFT MD PA
Entity Type:Organization
Organization Name:DELOS CLIFT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-472-0840
Mailing Address - Street 1:3000 N ORANGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7613
Mailing Address - Country:US
Mailing Address - Phone:407-472-0840
Mailing Address - Fax:407-472-0841
Practice Address - Street 1:3000 N ORANGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7613
Practice Address - Country:US
Practice Address - Phone:407-472-0840
Practice Address - Fax:407-472-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME607892086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2068831OtherAETNA HMO
FL2380840009OtherCIGNA
FL12931OtherBLUE CROSS/BLUE SHIELD
FLA004OtherTRICARE
FL211537OtherAVMED