Healthcare Provider Details

I. General information

NPI: 1982058806
Provider Name (Legal Business Name): ANEL DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 AVE SAN MARCOS URB EL COMANDANTE
CAROLINA PR
00982-3759
US

IV. Provider business mailing address

312 AVE SAN MARCOS URB EL COMANDANTE
CAROLINA PR
00982-3759
US

V. Phone/Fax

Practice location:
  • Phone: 787-207-2689
  • Fax:
Mailing address:
  • Phone: 787-207-2689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2458
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: