Provider Demographics
NPI:1619729274
Name:DELGADO LORENZO, JOSE ARTURO
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ARTURO
Last Name:DELGADO LORENZO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2411
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2411
Mailing Address - Country:US
Mailing Address - Phone:787-472-2864
Mailing Address - Fax:787-864-0400
Practice Address - Street 1:128 CALLE ASHFORD S STE 201
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-5421
Practice Address - Country:US
Practice Address - Phone:787-866-0000
Practice Address - Fax:787-864-0400
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR924363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant