Provider Demographics
NPI:1396903308
Name:PANAMERICAN INTERNAL MEDICINE INC
Entity type:Organization
Organization Name:PANAMERICAN INTERNAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:YAMILA
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-410-2887
Mailing Address - Street 1:2814 LEE BLVD STE 15
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1561
Mailing Address - Country:US
Mailing Address - Phone:239-303-7726
Mailing Address - Fax:239-491-0719
Practice Address - Street 1:2814 LEE BLVD STE 15
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1561
Practice Address - Country:US
Practice Address - Phone:239-246-1136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100544302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000052800Medicaid
FL0000Medicaid
1275521619OtherNPI