Active NPI
Adriana Jennice Ibanez Deleon, MD
- General Practice Physician
- Eglin Afb, FL
National Provider Identifier
1093555914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- W2514
- Practice address
- 307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302 - Phone
- (850) 883-8600
- NPI assigned
- May 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | W2514 | TX | Primary |
Addresses
Primary practice location
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Mailing address
307 Boatner Rd Ste 114
Eglin, FL 32542-1302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W2514 | TX | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1093555914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN",
"state": "FL",
"postal_code": "325421302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421302",
"telephone_number": "850-883-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBANEZ DELEON",
"first_name": "ADRIANA",
"middle_name": "JENNICE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-29",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "TX",
"license": "W2514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eglin Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.