Provider Demographics
NPI:1801889688
Name:DELGADO, JOSE O (M D)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:O
Last Name:DELGADO
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 SE 1ST AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0478
Mailing Address - Country:US
Mailing Address - Phone:352-873-2880
Mailing Address - Fax:352-873-8751
Practice Address - Street 1:2801 SE 1ST AVE STE 302
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-873-2880
Practice Address - Fax:352-873-8751
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269865000Medicaid
18164VMedicare PIN
FLF43594Medicare UPIN