Provider Demographics
NPI:1639278419
Name:DELGADO, LIVIA AMERICA (MD)
Entity Type:Individual
Prefix:
First Name:LIVIA
Middle Name:AMERICA
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 1:8550 W FLAGLER ST STE 109
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2037
Mailing Address - Country:US
Mailing Address - Phone:305-222-8755
Mailing Address - Fax:305-228-0039
Practice Address - Street 1:8550 W FLAGLER ST STE 109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2037
Practice Address - Country:US
Practice Address - Phone:305-222-8755
Practice Address - Fax:305-228-0039
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83104208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262421400Medicaid
H53827Medicare UPIN