Individual
GARY JAY DELLERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2402 EMBASSY DR, WEST PALM BEACH, FL 33401-1013
(561) 689-4747
Mailing address
2402 EMBASSY DR, WEST PALM BEACH, FL 33401-1013
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME 15790
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME 15790
STATE OF FLORIDA DEPT. OF HEALTH DIVISION OF MEDICAL QUALITY INSURANCE
FL
Enumeration date
01/18/2017
Last updated
01/18/2017
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