Healthcare Provider Details

I. General information

NPI: 1225615339
Provider Name (Legal Business Name): STEFANIE DELGADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4279 NW 88TH AVE
SUNRISE FL
33351-6044
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 954-741-4280
  • Fax: 954-741-4912
Mailing address:
  • Phone: 954-967-6400
  • Fax: 954-337-5755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME169419
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: