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General NPI Number Information
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NPI Number | 1083243604
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Entity Type | Individual
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Provider Name | JEAN BAPTISTE DELVA PA
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Gender | Male
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 6003 SNOWY EGRET LN
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City | GREENACRES
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State | FL
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Zip | 33415-1528
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Country | US
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Telephone | 561-635-7012
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Fax |
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Provider Business Mailing Address
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Address Line | 6003 SNOWY EGRET LN
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City | GREENACRES
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State | FL
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Zip | 33415-1528
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 000372-P.A.
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TPPA633
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10183
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License Number State | AZ
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