Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 7597 | PR |
NPI | 1306871140 |
---|---|
Provider Name | Dr. Juan J Maldonado |
First Address | Utuado, PR 00641-0272 |
Second Address | Utuado, PR 00641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 26/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H66894 | (02) | PR |