Healthcare Provider Details

I. General information

NPI: 1730875774
Provider Name (Legal Business Name): DEBORAH DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 01/20/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 BUDINGER AVE
SAINT CLOUD FL
34769-7203
US

IV. Provider business mailing address

3152 WAKE UP CT
KISSIMMEE FL
34744-9434
US

V. Phone/Fax

Practice location:
  • Phone: 407-498-4079
  • Fax:
Mailing address:
  • Phone: 407-301-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: