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General NPI Number Information
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NPI Number | 1982890174
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Entity Type | Organization
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Legal Business Name | DELTA HEALTH, PA
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 11349 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-597-0022
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Fax | 732-607-5118
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Provider Business Mailing Address
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Address Line | 11349 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-597-0022
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Fax | 732-607-5118
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAHMOUD BOURGHLI
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Credential | M.D.
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Telephone | 352-597-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME79929
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License Number State | FL
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