MEDICARE: MR. CARLOS F VIERA MALDONADO M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	24947	PR

General Provider Information

NPI Number	:	1316694755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARLOS F VIERA MALDONADO M.D

Provider Business Mailing Address
First Line	:	PO BOX 464
Second Line	:
City	:	BARRANQUITAS
State	:	PR
Zip	:	00794
Country	:	US
Telephone Number	:	939-225-0564
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 AVE LAUREL
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00956-4816
Country	:	US
Telephone Number	:	787-787-5151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2022
Last Update Date	:	06/03/2026

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