Provider Demographics
NPI:1780602516
Name:RICARDO S. DELGADO, M.D., P.A.
Entity type:Organization
Organization Name:RICARDO S. DELGADO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:S
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-210-6100
Mailing Address - Street 1:34041 US 19 N
Mailing Address - Street 2:SUITE B
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2648
Mailing Address - Country:US
Mailing Address - Phone:727-210-6100
Mailing Address - Fax:727-210-6105
Practice Address - Street 1:34041 US 19 N
Practice Address - Street 2:SUITE B
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2648
Practice Address - Country:US
Practice Address - Phone:727-210-6100
Practice Address - Fax:727-210-6105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE34013Medicare UPIN