1194867309 NPI number — DR. FELIX MALDONADO DDS

Table of content: DR. FELIX MALDONADO DDS (NPI 1194867309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194867309 NPI number — DR. FELIX MALDONADO DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALDONADO
Provider First Name:
FELIX
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194867309
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE ZARZUELA SE-35
Provider Second Line Business Mailing Address:
MANSION DEL SUR
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00949
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-785-2061
Provider Business Mailing Address Fax Number:
787-785-2061

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 78 BLOQUE 92 #3 FRENTE PARQUE DE LAS CIENCIAS
Provider Second Line Business Practice Location Address:
SIERRA BAYAMON
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-785-2061
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  1803 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)