Wanda Evelyn Delgado Rodriguez, MD
Individual provider Active NPI General Practice Physician · Camuy, PR
NPI 1689378705 · NPPES record last updated Jun 25, 2023
Key facts
- NPI
- 1689378705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 23320 (PR)
- Practice address
- Carr 2 KM 96.5 Interior Lote 5 Bo Yeguada
Camuy, PR 00627-7359 - Phone
- (787) 400-0150
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241016004503 | PR | Practitioner - General Practice | 3678012515 | Practice locations: Hatillo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 802-PA | PR | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 802-PA | PR | |
| General Practice Physician | 208D00000X | 23320 | PR | Yes |
Addresses
Primary practice location
Carr 2 KM 96.5 Interior Lote 5 Bo Yeguada
Camuy, PR 00627-7359
Mailing address
HC 3 Box 12704
Camuy, PR 00627-7359
Phone (787) 400-0150
Other providers in Camuy, PR
- Neylanie Cubero Rivera
- Cuidados Primarios del Norte
- David Gonzalez Hernandez
- Carolina De Jesus-Acosta
- Juan Gabriel Del Rio
- Mirelis Diaz Caparroz
- Loren Y Diaz Ramos
- Xavier Domenech Santiago
- Iris Viviana Dorta
- Dr Cesar H Medina Inc
All providers in Camuy, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.