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General NPI Number Information
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NPI Number | 1780613950
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Entity Type | Organization
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Legal Business Name | DELCARE, PA
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 1400 US HWY 441 N., SUITE 924
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City | THE VILLAGES
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State | FL
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Zip | 32159-1884
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Country | US
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Telephone | 352-751-7355
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Fax | 352-753-3455
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Provider Business Mailing Address
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Address Line | 1400 US HWY 441 N., SUITE 924
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City | THE VILLAGES
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State | FL
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Zip | 32159-1884
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Country | US
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Telephone | 352-751-7355
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Fax | 352-753-3455
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FARIBORZ DELBAKHSH
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Credential | M.D.
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Telephone | 352-751-7355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME79659
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License Number State | FL
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