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General NPI Number Information
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NPI Number | 1427902329
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Entity Type | Organization
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Legal Business Name | DISA HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 4900 W OAKLAND PARK BLVD STE 202
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1501
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Country | US
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Telephone | 516-418-4184
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 W OAKLAND PARK BLVD STE 202
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1501
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Country | US
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Telephone | 516-418-4184
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JERRY DELY
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Credential | MD
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Telephone | 561-418-4184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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