Provider Demographics
NPI:1548572084
Name:DELEDDA, NATHAN (DC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:DELEDDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 NOKOMIS AVE S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2319
Mailing Address - Country:US
Mailing Address - Phone:352-256-4980
Mailing Address - Fax:
Practice Address - Street 1:249 NOKOMIS AVE S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2319
Practice Address - Country:US
Practice Address - Phone:352-256-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor