Healthcare Provider Details

I. General information

NPI: 1386832525
Provider Name (Legal Business Name): DANIEL DELGADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 15TH ST
PANAMA CITY FL
32405-5412
US

IV. Provider business mailing address

525 E 15TH ST
PANAMA CITY FL
32405-5412
US

V. Phone/Fax

Practice location:
  • Phone: 850-522-4480
  • Fax: 850-914-6280
Mailing address:
  • Phone: 850-522-4480
  • Fax: 850-914-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME 96444
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: