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General NPI Number Information
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NPI Number | 1750062360
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Entity Type | Individual
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Provider Name | JEAN A DELICE
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Gender | Male
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 100 AVE LUIS MUNOZ MARIN
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City | CAGUAS
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State | PR
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Zip | 00725-6184
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Country | US
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Telephone | 787-920-4090
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Fax | 787-363-9900
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Provider Business Mailing Address
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Address Line | 100 AVE LUIS MUNOZ MARIN
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City | CAGUAS
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State | PR
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Zip | 00725-6184
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Country | US
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Telephone | 787-920-4090
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Fax | 787-363-9900
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001190-P.A
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10073
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License Number State | AZ
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