Healthcare Provider Details

I. General information

NPI: 1023597358
Provider Name (Legal Business Name): ABIGAIL D MALDONADO CAQUIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 CALLE PROF. AUGUSTO RODRIGUEZ CONDOMINIO ASIA, SUITE 600
SAN JUAN PR
00909
US

IV. Provider business mailing address

1503 CALLE PROF. AUGUSTO RODRIGUEZ CONDOMINIO ASIA, SUITE 600
SAN JUAN PR
00909
US

V. Phone/Fax

Practice location:
  • Phone: 787-497-0800
  • Fax: 787-982-6464
Mailing address:
  • Phone: 787-497-0800
  • Fax: 787-982-6464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: