Provider Demographics
NPI:1205177318
Name:DRA. ADALIZZIE DELGADO & ASOCIADOS PSC
Entity type:Organization
Organization Name:DRA. ADALIZZIE DELGADO & ASOCIADOS PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:ADA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:11110
Authorized Official - Phone:787-780-9212
Mailing Address - Street 1:BAYAMON MEDICAL PLAZA
Mailing Address - Street 2:SUITE 902
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-780-9212
Mailing Address - Fax:787-785-9212
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE 902
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-780-9212
Practice Address - Fax:787-785-9212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADA DELGADO MATEO MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11110302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1992795975Medicare PIN