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General NPI Number Information
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NPI Number | 1679739239
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Entity Type | Individual
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Provider Name | MRS. ROSA G MALDONADO ESPARRA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | URB ENCANTADA PACIFICA P-G 72
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-518-4561
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Fax | 787-760-4862
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Provider Business Mailing Address
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Address Line | PMB 238 PO BOX 2500
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977-2500
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Country | US
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Telephone | 787-518-4561
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Fax | 787-760-4862
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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