Healthcare Provider Details

I. General information

NPI: 1265395719
Provider Name (Legal Business Name): JEAHNITSY DELGADO-TARRATS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1197
US

IV. Provider business mailing address

PO BOX 1348
NEWBERRY FL
32669-1348
US

V. Phone/Fax

Practice location:
  • Phone: 352-548-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11043267
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: