MEDICARE: IVETTE DELGADO

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	183500000X	Pharmacist	2572	PR

General Provider Information

NPI Number	:	1356987622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVETTE DELGADO

Provider Business Mailing Address
First Line	:	URB CIUDAD JARDIN III
Second Line	:	492 CALLE ALCANFOR
City	:	TOA ALTA
State	:	PR
Zip	:	00949-4893
Country	:	US
Telephone Number	:	787-565-2970
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB CIUDAD JARDIN III
Second Line	:	492 CALLE ALCANFOR
City	:	TOA ALTA
State	:	PR
Zip	:	00949-4893
Country	:	US
Telephone Number	:	787-565-2970
Fax Number	:

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

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	11/21/2019

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Directions to “ IVETTE DELGADO ” Practice Location

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