Healthcare Provider Details

I. General information

NPI: 1104908367
Provider Name (Legal Business Name): LIZBHET S DELGADO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 SW 149TH PASS
MIAMI FL
33185-5782
US

IV. Provider business mailing address

1822 SW 149TH PASS
MIAMI FL
33185-5782
US

V. Phone/Fax

Practice location:
  • Phone: 305-226-1300
  • Fax:
Mailing address:
  • Phone: 305-226-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPS 34267
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: