Healthcare Provider Details

I. General information

NPI: 1659478972
Provider Name (Legal Business Name): VICTOR LUIS DELGADO COLON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B24 CALLE 3
MANATI PR
00674-5409
US

IV. Provider business mailing address

PO BOX 77
MANATI PR
00674-0077
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-3065
  • Fax:
Mailing address:
  • Phone: 787-884-3065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7907
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number7907
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number7907
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: