Healthcare Provider Details

I. General information

NPI: 1972223709
Provider Name (Legal Business Name): CORRINE ALEXIA DELGRECO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 LINTON BLVD STE H1
DELRAY BEACH FL
33484-6597
US

IV. Provider business mailing address

9379 COBBLESTONE BROOKE CT
BOYNTON BEACH FL
33472-4429
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-8891
  • Fax:
Mailing address:
  • Phone: 561-573-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11009289
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: