1275702243 NPI number — YOLANDA MALDONADO MALDONADO MT

Table of content: YOLANDA MALDONADO MALDONADO MT (NPI 1275702243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275702243 NPI number — YOLANDA MALDONADO MALDONADO MT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALDONADO MALDONADO
Provider First Name:
YOLANDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALMENDROS
Provider Other First Name:
LABORATORIO
Provider Other Middle Name:
CLINICO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1275702243
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CC 35 CALLE CEIBA
Provider Second Line Business Mailing Address:
RIO HONDO III
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00961-3419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-785-1233
Provider Business Mailing Address Fax Number:
787-780-2622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CC 35 CALLE CEIBA
Provider Second Line Business Practice Location Address:
RIO HONDO III
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-3419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-785-1233
Provider Business Practice Location Address Fax Number:
787-780-2622
Provider Enumeration Date:
02/25/2008

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: 247ZC0005X , with the licence number:  1665 , 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)

  • Identifier: 660397575 . This is a "CIGNA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660397575 . This is a "TRICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 51018 . This is a "CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30349 . This is a "TRIPLE-S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6200024 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660397575 . This is a "MCS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660397575 . This is a "UHC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7675 . This is a "IMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8000209 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660397575 . This is a "MAPFRE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1275627234 . This is a "PROSSAM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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