Healthcare Provider Details

I. General information

NPI: 1942966957
Provider Name (Legal Business Name): CLAUDIA PATRICIA MALDONADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2021
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8353 SW 124TH ST STE 102
MIAMI FL
33156-5847
US

IV. Provider business mailing address

6435 SW 130TH AVE APT 311
MIAMI FL
33183-5241
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-6435
  • Fax:
Mailing address:
  • Phone: 305-282-6234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number19-95829
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: