Healthcare Provider Details

I. General information

NPI: 1205354214
Provider Name (Legal Business Name): EMILY RUTH DELGADO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2043 LITTLE RD
TRINITY FL
34655-4421
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 727-846-7000
  • Fax: 877-260-1182
Mailing address:
  • Phone: 727-846-7000
  • Fax: 877-260-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN9495964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: