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General NPI Number Information
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NPI Number | 1205462520
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Entity Type | Individual
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Provider Name | MRS. LIZETTE M DELGADO
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Gender | Female
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 7777 131ST ST STE 7
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City | SEMINOLE
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State | FL
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Zip | 33776-4015
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Country | US
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Telephone | 727-224-5301
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Fax |
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Provider Business Mailing Address
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Address Line | 12215 30TH ST E
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City | PARRISH
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State | FL
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Zip | 34219-1608
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Country | US
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Telephone | 908-397-8792
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-67133
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License Number State | FL
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