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General NPI Number Information
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NPI Number | 1578949491
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Entity Type | Individual
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Provider Name | TAMIA ANNA MALDONADO
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Gender | Female
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 9821 NW 24TH CT
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City | SUNRISE
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State | FL
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Zip | 33322-1900
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Country | US
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Telephone | 954-232-4647
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Fax |
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Provider Business Mailing Address
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Address Line | 9821 NW 24TH CT
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City | SUNRISE
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State | FL
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Zip | 33322-1900
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Country | US
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Telephone | 954-232-4647
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN 9180541
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License Number State | FL
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