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General NPI Number Information
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NPI Number | 1013212166
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Entity Type | Organization
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Legal Business Name | ANABELLE MALDONADO-MEDINA M.D P A
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 9999 NE 2ND AVE STE 208
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City | MIAMI SHORES
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State | FL
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Zip | 33138
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Country | US
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Telephone | 305-836-5053
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Fax | 305-836-9727
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Provider Business Mailing Address
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Address Line | 9999 NE 2ND AVE STE 208
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2345
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Country | US
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Telephone | 305-836-5053
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Fax | 305-836-9727
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Authorized Official
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Title or Position | M.D
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Name | DR. ANABELLE MALDONADO-MEDINA
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Credential | M.D
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Telephone | 305-836-5053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0049821
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License Number State | FL
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