Organization Active NPI

Panamerican Internal Medicine Inc

  • Health Maintenance Organization
  • Lehigh Acres, FL
National Provider Identifier
1396903308
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
ME100544 Issued in FL
Legal business name
PANAMERICAN INTERNAL MEDICINE INC
Practice address
2814 Lee Blvd Ste 15
Lehigh Acres, FL 33971-1561
Phone
(239) 246-1136
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Authorized official

Name
Dr. Dolores Yamila Delgado, MDNPI 1275521619
Title
MD
Phone
(239) 410-2887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X ME100544 FL Primary

Addresses

Primary practice location

2814 Lee Blvd Ste 15
Lehigh Acres, FL 33971-1561

Mailing address

2814 Lee Blvd Ste 15
Lehigh Acres, FL 33971-1561
Phone (239) 303-7726

Other identifiers 3

IdentifierTypeStateIssuer
000052800MedicaidFL
0000MedicaidFL
1275521619OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080804000627 FL Part B Supplier - Clinic/Group Practice 5597839845 Receives reassigned benefits from 2 practitioners
Practice locations: Lehigh Acres, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1098350Panamerican Internal Medicine Inc2814 Lee Blvd Ste 15, Lehigh Acres, FL 33971Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory

Locations

13100 Westlinks Ter
Ste 10
Fort Myers, FL 33913
Phone (239) 246-1136

2814 Lee Blvd
Ste 15
Lehigh Acres, FL 33971
Phone (239) 303-7726

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1396903308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 LEE BLVD STE 15",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711561",
            "telephone_number": "239-303-7726",
            "fax_number": "239-491-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 LEE BLVD STE 15",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711561",
            "telephone_number": "239-246-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANAMERICAN INTERNAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "DOLORES",
        "authorized_official_middle_name": "YAMILA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "239-410-2887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "ME100544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000052800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275521619",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.