Healthcare Provider Details

I. General information

NPI: 1295899540
Provider Name (Legal Business Name): LINNETE MALDONADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CEMPRI OROCOVIS
OROCOVIS PR
00720
US

IV. Provider business mailing address

BO. GATO SECTOR BAJARES PO BOX 1221
OROCOVIS PR
00720
US

V. Phone/Fax

Practice location:
  • Phone: 787-869-1290
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number4473
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: