Individual
WANDA I AGOSTO DELGADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
CALLE ULISES MARTINEZ #52, HUMACAO, PR 00791
(787) 852-3283
Mailing address
PO BOX 8754, HUMACAO, PR 00792-8754
(787) 852-3283
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9514
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9514
MD LISCENCE
PR
Enumeration date
02/14/2007
Last updated
07/08/2007
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