Ivan Delgado, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL3483 Issued in FL

Practice address

1501 NE 62ND St
Fort Lauderdale, FL 33334-5116

Phone

(954) 776-2124

Fax

(954) 492-4562

NPI assigned

Feb 16, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pine Crest School

  • Health Educator
  • Ft Lauderdale, FL
  • NPI 1609278704
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1275924920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NE 62ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333345116",
            "telephone_number": "954-776-2124",
            "fax_number": "954-492-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NE 62ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333345116",
            "telephone_number": "954-776-2124",
            "fax_number": "954-492-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "IVAN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delaware Valley Physical Medicine Associates
• Nicolle Anne Deleo, PSY D
• Natalie Deleon, MSW, LCSW
• Domingo Delgado-Garcia, MD
• Cypres Banuelos Delgado
• Alicia Delisser-Nuttal
• Siena Delisser, LMFT
• Deliverance Center Outreach Ministry for Christ
• Una Della-Pietra, DO
• Changlena Delpe

• Athletic Trainer in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.