Provider Demographics
NPI:1629708607
Name:DELGADO JIMENEZ, EUGENIO (APRN)
Entity Type:Individual
Prefix:
First Name:EUGENIO
Middle Name:
Last Name:DELGADO JIMENEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 NE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5575
Mailing Address - Country:US
Mailing Address - Phone:305-815-2237
Mailing Address - Fax:
Practice Address - Street 1:7887 N KENDALL DR STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7494
Practice Address - Country:US
Practice Address - Phone:305-279-7722
Practice Address - Fax:305-279-2090
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020142207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine