Healthcare Provider Details

I. General information

NPI: 1154290948
Provider Name (Legal Business Name): DELTORA MEDIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE A
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE A
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 302-546-4112
  • Fax:
Mailing address:
  • Phone: 302-546-4112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. SELWYN PEREIRA
Title or Position: AUTORIZED OFFICIAL
Credential:
Phone: 979-551-5742