Provider Demographics
NPI:1639416571
Name:DELGADO, KERRIE KATHLEEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KERRIE
Middle Name:KATHLEEN
Last Name:DELGADO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12975 COLLIER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-4004
Mailing Address - Country:US
Mailing Address - Phone:239-348-7806
Mailing Address - Fax:239-352-8120
Practice Address - Street 1:12975 COLLIER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-4004
Practice Address - Country:US
Practice Address - Phone:239-348-7806
Practice Address - Fax:239-352-8120
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist