MEDICARE: LINDA FAY DELO DO PA

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	207Q00000X	Family Medicine Physician	OS5326	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0112160	OTHER	FL	GHI
2	82976	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1225033848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA FAY DELO DO PA

Provider Business Mailing Address
First Line	:	514 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-5108
Country	:	US
Telephone Number	:	772-871-5900
Fax Number	:	772-871-1197

Provider Business Practice Location Address
First Line	:	514 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-5108
Country	:	US
Telephone Number	:	772-871-5900
Fax Number	:	772-871-1197

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	02/25/2026

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