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General NPI Number Information
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NPI Number | 1114810165
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Entity Type | Individual
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Provider Name | CAROLINA MALDONADO C ORREA
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Gender | Female
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2950 CLEVELAND CLINIC BLVD
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City | WESTON
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State | FL
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Zip | 33331-3609
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Country | US
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Telephone | 954-659-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 555 BRUSH ST APT 909
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City | DETROIT
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State | MI
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Zip | 48226-4331
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Country | US
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Telephone | 787-923-1400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY12750
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License Number State | FL
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