Provider Demographics
NPI:1659649895
Name:DELGADO, ZACARIAS RENE (ATC)
Entity Type:Individual
Prefix:
First Name:ZACARIAS
Middle Name:RENE
Last Name:DELGADO
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 COLESVILLE RD
Mailing Address - Street 2:STE 50
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3399
Mailing Address - Country:US
Mailing Address - Phone:301-588-7888
Mailing Address - Fax:301-587-5002
Practice Address - Street 1:8401 COLESVILLE RD
Practice Address - Street 2:STE 50
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3399
Practice Address - Country:US
Practice Address - Phone:301-588-7888
Practice Address - Fax:301-588-3419
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00003122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer