MEDICARE: PANAMERICAN INTERNAL MEDICINE INC

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	302R00000X	Health Maintenance Organization	ME100544	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1275521619	OTHER	NPI

General Provider Information

NPI Number	:	1396903308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANAMERICAN INTERNAL MEDICINE INC

Provider Business Mailing Address
First Line	:	2814 LEE BLVD STE 15
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33971-1561
Country	:	US
Telephone Number	:	239-303-7726
Fax Number	:	239-491-0719

Provider Business Practice Location Address
First Line	:	2814 LEE BLVD STE 15
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33971-1561
Country	:	US
Telephone Number	:	239-246-1136
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	DR. DOLORES YAMILA DELGADO
Credential	:	MD
Telephone Number	:	239-410-2887

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	11/28/2022

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Directions to “PANAMERICAN INTERNAL MEDICINE INC ” Practice Location

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