Healthcare Provider Details

I. General information

NPI: 1164092995
Provider Name (Legal Business Name): DEBBIE DELVA PHLEBOTOMIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBBIE DELVA MOBILE PHLEBOTOMIST

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 NE 38TH ST APT A210
OAKLAND PARK FL
33334-1278
US

IV. Provider business mailing address

251 NE 38TH ST APT A210
OAKLAND PARK FL
33334-1278
US

V. Phone/Fax

Practice location:
  • Phone: 954-501-1737
  • Fax:
Mailing address:
  • Phone: 954-501-1737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberL21000146806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: