Healthcare Provider Details

I. General information

NPI: 1700130085
Provider Name (Legal Business Name): MARTHA MALDONADO ALKHALDI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. MARTHA MALDONADO

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 09/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73 ST
SOUTH MIAMI FL
33143
US

IV. Provider business mailing address

9181 SW 170 AVE
MIAMI FL
33196
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-5465
  • Fax:
Mailing address:
  • Phone: 305-281-4416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9254390
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: