Provider Demographics
NPI:1295963155
Name:DELUCCA JIMENEZ, HECTOR (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:DELUCCA JIMENEZ
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 1:201 CALLE GAUTIER BENITEZ STE 400
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5527
Mailing Address - Country:US
Mailing Address - Phone:787-957-8282
Mailing Address - Fax:787-665-1165
Practice Address - Street 1:201 CALLE GAUTIER BENITEZ STE 400
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-957-8282
Practice Address - Fax:787-665-1165
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR206192081P2900X, 208VP0000X, 2081P2900X, 208VP0014X
FLME1150162081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty