MEDICARE: MRS. MARIA ROSARIO BRASIL-DELGADO FNP

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	363L00000X	Nurse Practitioner	NP 17207	CA

General Provider Information

NPI Number	:	1891904389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA ROSARIO BRASIL-DELGADO FNP

Provider Business Mailing Address
First Line	:	823 GATEWAY CENTER WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-4541
Country	:	US
Telephone Number	:	619-515-2323
Fax Number	:	619-906-4564

Provider Business Practice Location Address
First Line	:	1145 BROADWAY AVENUE
Second Line	:	DOWNTOWN FAMILY HEALTH CENTER
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-5611
Country	:	US
Telephone Number	:	619-515-2525
Fax Number	:	619-233-3067

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	10/26/2010

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