Provider Demographics
NPI:1962011536
Name:DELGADO BRITO, JUAN ALBERTO
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:ALBERTO
Last Name:DELGADO BRITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FONTAINEBLEAU BLVD APT 307
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4571
Mailing Address - Country:US
Mailing Address - Phone:786-263-1179
Mailing Address - Fax:
Practice Address - Street 1:110 FONTAINEBLEAU BLVD APT 307
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4571
Practice Address - Country:US
Practice Address - Phone:786-263-1179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator