Healthcare Provider Details

I. General information

NPI: 1780996884
Provider Name (Legal Business Name): SILVIA MARIA DEL ROCIO DELGADO VILLALTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100296
GAINESVILLE FL
32610-0296
US

IV. Provider business mailing address

PO BOX 100296
GAINESVILLE FL
32610-0296
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-8379
  • Fax: 352-294-8098
Mailing address:
  • Phone: 352-273-8379
  • Fax: 352-294-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD038673
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD76041
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: