Basic Information
| Provider Information | |||||||||
| NPI: | 1003001736 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELGADO | ||||||||
| FirstName: | ROLANDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1135 | ||||||||
| Address2: | |||||||||
| City: | YAUCO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006981135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874257824 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CARR.128 K.M.2.2 BO.SUSUA BAJA | ||||||||
| Address2: | SUITE 106 YAUCO GALLERY | ||||||||
| City: | YAUCO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878565757 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2007 | ||||||||
| LastUpdateDate: | 09/06/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 00338 | PR | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.