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General NPI Number Information
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NPI Number | 1558507681
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Entity Type | Individual
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Provider Name | MARICARMEN LOPEZ MALDONADO M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | BAYAMON MEDICAL PLAZA SUITE 309
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City | BAYAMON
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State | PR
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Zip | 00959-7200
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Country | US
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Telephone | 787-379-7533
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2278
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City | BAYAMON
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State | PR
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Zip | 00960-2278
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Country | US
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Telephone | 787-379-7533
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 18745
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18745
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License Number State | PR
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