MEDICARE: DELIGHT MEDICAL CLINIC

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	261QP2300X	Primary Care Clinic/Center	ME103322	FL

General Provider Information

NPI Number	:	1912211293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELIGHT MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	789 NW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3012
Country	:	US
Telephone Number	:	305-960-7608
Fax Number	:	305-381-5039

Provider Business Practice Location Address
First Line	:	789 NW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3012
Country	:	US
Telephone Number	:	305-960-7608
Fax Number	:	305-381-5039

Authorized Official
Title or Position	:	MEDICAL DIRECTOR/OWNER
Name	:	MARDELLE DELIGHT
Credential	:	M.D.
Telephone Number	:	305-960-7608

Provider Enumeration Date	:	07/29/2010
Last Update Date	:	05/10/2011

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Directions to “DELIGHT MEDICAL CLINIC ” Practice Location

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