Provider Demographics
NPI:1841774395
Name:DELMAS, VICKY
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:DELMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9861 PATRIOT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-5619
Mailing Address - Country:US
Mailing Address - Phone:305-788-0313
Mailing Address - Fax:
Practice Address - Street 1:9861 PATRIOT RIDGE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-5619
Practice Address - Country:US
Practice Address - Phone:305-788-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion