Healthcare Provider Details

I. General information

NPI: 1932291051
Provider Name (Legal Business Name): YANNETTE GUZMAN MALDONADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 KM 49 5 PROFESSIONAL HOSPITAL
MANATI PR
00674
US

IV. Provider business mailing address

BOX 180
COROZAL PR
00783
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-0505
  • Fax: 787-884-0510
Mailing address:
  • Phone: 787-870-4583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number15742
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: