Provider Demographics
NPI:1659478972
Name:DELGADO COLON, VICTOR LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LUIS
Last Name:DELGADO COLON
Suffix:
Gender:M
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:PO BOX 77
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0077
Mailing Address - Country:US
Mailing Address - Phone:787-884-3065
Mailing Address - Fax:
Practice Address - Street 1:B24 CALLE 3
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5409
Practice Address - Country:US
Practice Address - Phone:787-884-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7907207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR27085OtherTRIPLE SSS
PRPG2091OtherPALIC
PR066236OtherCRUZ AZUL
PR1708OtherINTERNATIONAL MEDICAL CAR
PR0010095OtherHUMANA PUERTO RICO
PR660429847OtherCOSVI
PR066236OtherCRUZ AZUL
PR1708OtherINTERNATIONAL MEDICAL CAR