Provider Demographics
NPI:1366812711
Name:DELGADO, ADALYS M
Entity type:Individual
Prefix:DR
First Name:ADALYS
Middle Name:M
Last Name:DELGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 CALLE ROBLE
Mailing Address - Street 2:CIUDAD JARDIN III
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-243-4844
Mailing Address - Fax:
Practice Address - Street 1:B1 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 309
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6928
Practice Address - Country:US
Practice Address - Phone:787-740-4465
Practice Address - Fax:787-785-2680
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4323283171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator