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General NPI Number Information
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NPI Number | 1467649905
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Entity Type | Individual
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Provider Name | CARLOS I MALDONADO SANTOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | MEDICAL OPHTHALMIC PLAZA SUITE 101 CARR. #2 KM. 11.9
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-787-0250
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Fax |
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Provider Business Mailing Address
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Address Line | MEDICAL OPHTHALMIC PLAZA SUITE 101 CARR. #2 KM. 11.9
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-787-0250
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18269
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License Number State | PR
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