Provider Demographics
NPI:1174194260
Name:DELGADO, MARTHA LILIANA (APRN)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:LILIANA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4576 SW BIMINI CIR S
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-1351
Mailing Address - Country:US
Mailing Address - Phone:772-204-1887
Mailing Address - Fax:772-877-0743
Practice Address - Street 1:4576 SW BIMINI CIR S
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-1351
Practice Address - Country:US
Practice Address - Phone:772-204-1887
Practice Address - Fax:772-877-0743
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily