MEDICARE: LIONEL DELGADO HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	DH-35218	FL

General Provider Information

NPI Number	:	1023958071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIONEL DELGADO HERNANDEZ

Provider Business Mailing Address
First Line	:	1635 55TH AVENUE CIR E APT 105
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-4475
Country	:	US
Telephone Number	:	941-226-9948
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 55TH AVENUE CIR E APT 105
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-4475
Country	:	US
Telephone Number	:	941-226-9948
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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