Provider Demographics
NPI:1578539821
Name:DELGADO, MADELYN (MD)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AVE JESUS T PINERO
Mailing Address - Street 2:APT. 10-E, CONDOMINIO HATO REY PLAZA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4105
Mailing Address - Country:US
Mailing Address - Phone:787-635-9691
Mailing Address - Fax:787-751-1937
Practice Address - Street 1:200 AVE JESUS T PINERO
Practice Address - Street 2:APT. 10-E, CONDOMINIO HATO REY PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4105
Practice Address - Country:US
Practice Address - Phone:787-635-9691
Practice Address - Fax:787-751-1937
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5910174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist