Provider Demographics
NPI:1396900148
Name:REMALEY, DELBERT PAUL III (DO)
Entity type:Individual
Prefix:
First Name:DELBERT
Middle Name:PAUL
Last Name:REMALEY
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:REMALEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13330 USF LAUREL DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6601
Practice Address - Country:US
Practice Address - Phone:813-396-9195
Practice Address - Fax:813-396-9495
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11721207X00000X
OH34011038207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14V2KOtherBLUE CROSS BLUE SHIELD
FL012738500Medicaid
FLHW432ZMedicare PIN
FL012738500Medicaid