Provider Demographics
NPI:1184504839
Name:DELGADO PEREZ, AILYN
Entity type:Individual
Prefix:
First Name:AILYN
Middle Name:
Last Name:DELGADO PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 MASSACHUSETTS AVE NE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-4318
Mailing Address - Country:US
Mailing Address - Phone:786-821-9238
Mailing Address - Fax:
Practice Address - Street 1:500 110TH AVE N APT 901
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3154
Practice Address - Country:US
Practice Address - Phone:786-821-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty