Healthcare Provider Details

I. General information

NPI: 1164006276
Provider Name (Legal Business Name): LIVIA A. DELGADO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9580 SW 107TH AVE STE 203
MIAMI FL
33176-2792
US

IV. Provider business mailing address

9580 SW 107TH AVE STE 203
MIAMI FL
33176-2792
US

V. Phone/Fax

Practice location:
  • Phone: 305-222-8755
  • Fax: 305-228-0039
Mailing address:
  • Phone: 305-222-8755
  • Fax: 305-228-0039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LIVIA AMERICA DELGADO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-222-8755