Provider Demographics
NPI:1730138710
Name:DELTOR, PIERRE (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:
Last Name:DELTOR
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 1:400 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2917
Mailing Address - Country:US
Mailing Address - Phone:561-429-2401
Mailing Address - Fax:
Practice Address - Street 1:400 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2917
Practice Address - Country:US
Practice Address - Phone:561-429-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86340207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78605OtherBCBS
FL266744400Medicaid
FL266744400Medicaid
FL78605WMedicare PIN