Most Relevant Information
Provider Data
| NPI Number: | 1003508748 |
| Provider Name: | TAMMY DELIGAR SMALL LDO |
| Entity Type: | Individual |
| Taxonomy Code: | 156FX1800X |
| Specialty: | Technician/Technologist |
| License Number: | DO3139 |
Most Important Dates
| Enumeration Date: | 05/22/2023 |
| Last Updated: | 05/22/2023 |
Provider Practice Location
10991 SAN JOSE BLVD STE 1
JACKSONVILLE
FL
322236600
Practice Location Phone/Fax
| Phone: | 9042602719 |
| Fax: | 9042608878 |
Provider Mailing Location
2819 BEGONIA RD
JACKSONVILLE
FL
322092301
Provider Mailing Phone/Fax
| Phone: | 9044101410 |
| Fax: |