1275627234 NPI number — YOLANDA MALDONADO MALDONADO

Table of content: (NPI 1275627234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275627234 NPI number — YOLANDA MALDONADO MALDONADO

Organization/Personal Information

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

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1275627234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
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:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MALDONADO
Authorized Official First Name:
YOLANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-785-1233

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  568 , 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: 3-0349 . 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 . This identifiers is of the category "OTHER".
  • Identifier: 8000209 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7675 . This is a "IMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 51018 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1275627234 . This is a "PROSSAM" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com