Provider Demographics
NPI:1699791764
Name:DELGADO, JOSE ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALBERTO
Last Name:DELGADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0042
Mailing Address - Country:US
Mailing Address - Phone:787-621-3700
Mailing Address - Fax:787-621-3710
Practice Address - Street 1:CARR. # 2 INT. 668
Practice Address - Street 2:URB. ATENAS CALLE HERNANDEZ CARRION
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:787-621-3710
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-6398OtherCIGNA
PR067191OtherCRUZ AZUL
PR1112465OtherHUMANA GOBIERNO
PRN405OtherINTN'L MEDICAL CARD
PR1112465OtherACAA
PR9790020OtherHUMANA PUERTO RICO
PR29856Medicare ID - Type UnspecifiedMEDICARE
PR067191OtherCRUZ AZUL