Healthcare Provider Details

I. General information

NPI: 1912560194
Provider Name (Legal Business Name): GIULIANI TOMAS OLIVERAS MALDONADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARIBBEAN MEDICAL BUILDING AVE OSVALDO MOLINA ESQUINA CALLE GENERAL VALERO 375
FAJARDO PR
00738
US

IV. Provider business mailing address

CARIBBEAN MEDICAL BUILDING AVE OSVALDO MOLINA ESQUINA CALLE GENERAL VALERO 375
FAJARDO PR
00738
US

V. Phone/Fax

Practice location:
  • Phone: 787-705-8166
  • Fax:
Mailing address:
  • Phone: 787-705-8166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number023166
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: