Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DTP630 | FL |
NPI | 1003274002 |
---|---|
Provider Name | Mrs. Maria Gabriela Delgado Caraballo |
First Address | Gainesville, FL 32610-0415 |
Second Address | Gainesville, FL 32610-0415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2016 |
Last Update Date | 04/02/2016 |