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General NPI Number Information
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NPI Number | 1053766717
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Entity Type | Individual
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Provider Name | GUSTAVO DELGADO BRITO
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Gender | Male
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 777 E 25TH ST STE 312
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City | HIALEAH
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State | FL
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Zip | 33013-3849
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Country | US
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Telephone | 305-392-0380
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Fax | 305-603-9683
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Provider Business Mailing Address
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Address Line | 6980 NW 186TH ST # A520
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City | HIALEAH
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State | FL
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Zip | 33015-3171
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Country | US
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Telephone | 305-319-9105
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Fax | 787-801-1784
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9334048
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License Number State | FL
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