Healthcare Provider Details

I. General information

NPI: 1932045226
Provider Name (Legal Business Name): TAIREE NICHOLE DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BQN NORTHEAST RD 251 - 299
AGUADILLA PR
00602
US

IV. Provider business mailing address

PO BOX 60401
SAN ANTONIO PR
00690-9003
US

V. Phone/Fax

Practice location:
  • Phone: 787-675-9165
  • Fax:
Mailing address:
  • Phone: 787-675-9165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number6138664
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: