Healthcare Provider Details

I. General information

NPI: 1922186790
Provider Name (Legal Business Name): HECTOR L SANCHEZ MALDONADO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 5A MARG K1 URB VILLA REAL
VEGA BAJA PR
00693-0000
US

IV. Provider business mailing address

CALLE 5A MARG. K1 URB. VILLA REAL
VEGA BAJA PR
00693-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-858-2624
  • Fax: 787-858-2624
Mailing address:
  • Phone: 787-462-0573
  • Fax: 787-858-2624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number138
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number138
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: