MEDICARE: CRISANTO RAUL DELGADO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME84441	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366441487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISANTO RAUL DELGADO MD

Provider Business Mailing Address
First Line	:	110 S WOODLAND ST
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3546
Country	:	US
Telephone Number	:	407-905-8827
Fax Number	:	407-886-4282

Provider Business Practice Location Address
First Line	:	7300 SANDLAKE COMMONS BLVD STE 221
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-8011
Country	:	US
Telephone Number	:	407-601-1559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	06/03/2025

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