Provider Demographics
NPI:1053717819
Name:DELGADO, EDUARDO
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:DELGADO
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 1:9957 HIDDEN RIVER DR APT 206
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8607
Mailing Address - Country:US
Mailing Address - Phone:321-696-2849
Mailing Address - Fax:
Practice Address - Street 1:9957 HIDDEN RIVER DR APT 206
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8607
Practice Address - Country:US
Practice Address - Phone:321-696-2849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator