Provider Demographics
NPI:1124821228
Name:DELGADO, MARTIN (RPH)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:DELGADO
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0630
Mailing Address - Country:US
Mailing Address - Phone:787-356-3226
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1918
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-8918
Practice Address - Country:US
Practice Address - Phone:787-356-3226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist