Healthcare Provider Details

I. General information

NPI: 1932700564
Provider Name (Legal Business Name): KRISTYN DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8331 SW 37TH ST
MIAMI FL
33155-3305
US

IV. Provider business mailing address

8331 SW 37TH ST
MIAMI FL
33155-3305
US

V. Phone/Fax

Practice location:
  • Phone: 786-205-5882
  • Fax:
Mailing address:
  • Phone: 786-205-5882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: