Active NPI
Jennifer Delatola
- Internal Medicine Physician
- Beverly Hills, FL
National Provider Identifier
1548916794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 11018294
- Practice address
- 3775 N Lecanto Hwy
Beverly Hills, FL 34465-3559 - Phone
- (352) 746-0600
- NPI assigned
- Feb 25, 2022
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 11018294 | FL | Primary |
Addresses
Primary practice location
3775 N Lecanto Hwy
Beverly Hills, FL 34465-3559
Mailing address
3775 N Lecanto Hwy
Beverly Hills, FL 34465-3559
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11018294 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1548916794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3775 N LECANTO HWY",
"city": "BEVERLY HILLS",
"state": "FL",
"postal_code": "344653559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3775 N LECANTO HWY",
"city": "BEVERLY HILLS",
"state": "FL",
"postal_code": "344653559",
"telephone_number": "352-746-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELATOLA",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-25",
"last_updated": "2022-02-25",
"certification_date": "2022-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "11018294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.