Provider Demographics
NPI:1689672867
Name:DELGADO, MARIA I (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:I
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 1:43 NE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4506
Mailing Address - Country:US
Mailing Address - Phone:786-243-1909
Mailing Address - Fax:786-243-4292
Practice Address - Street 1:43 NE 15TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4506
Practice Address - Country:US
Practice Address - Phone:786-243-1909
Practice Address - Fax:786-243-4292
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65520208000000X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04680070OtherECFMG NUMBER
LA272981OtherWELLCARE
FL7308366OtherAETNA ID#
FL25106OtherBCBS ID#
FL25106TMedicare UPIN