Provider Demographics
NPI:1609847763
Name:MIRANDA DELGADO, HECTOR S (MD)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:S
Last Name:MIRANDA DELGADO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:365 DE DIEGO AVE
Mailing Address - Street 2:SAN FRANCISCO TOWER SUITE 409
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923
Mailing Address - Country:US
Mailing Address - Phone:787-767-5944
Mailing Address - Fax:787-765-5786
Practice Address - Street 1:365 DE DIEGO AVE
Practice Address - Street 2:SAN FRANCISCO TOWER SUITE 409
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-767-5944
Practice Address - Fax:787-765-5786
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2020-08-06
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Provider Licenses
StateLicense IDTaxonomies
PR99122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E63380Medicare UPIN