Provider Demographics
NPI:1891053104
Name:DELGADO-MATTERN, AMANDA NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:NICOLE
Last Name:DELGADO-MATTERN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:NICOLE
Other - Last Name:DELGADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:4300 S US HIGHWAY 1 STE 203-197
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-1198
Mailing Address - Country:US
Mailing Address - Phone:407-968-1500
Mailing Address - Fax:
Practice Address - Street 1:4300 S US HIGHWAY 1 STE 203-197
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-1198
Practice Address - Country:US
Practice Address - Phone:407-968-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor