Provider Demographics
NPI:1619934353
Name:DELEO, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DELEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:954-971-3210
Mailing Address - Fax:954-971-3427
Practice Address - Street 1:4570 LYONS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3481
Practice Address - Country:US
Practice Address - Phone:954-971-3210
Practice Address - Fax:954-971-3427
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL32668208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039101800Medicaid
D62980Medicare UPIN