Healthcare Provider Details

I. General information

NPI: 1700408572
Provider Name (Legal Business Name): DELAYNA GARCIA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 LOUISIANA BLVD NE STE 410
ALBUQUERQUE NM
87110-5412
US

IV. Provider business mailing address

2100 LOUISIANA BLVD NE SUITE 410
ALBUQUERQUE NM
87110
US

V. Phone/Fax

Practice location:
  • Phone: 505-724-4700
  • Fax:
Mailing address:
  • Phone: 505-724-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDO2024-0106
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: