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General NPI Number Information
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NPI Number | 1821186875
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Entity Type | Individual
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Provider Name | IONA KRYSTIN MALINOW-MACEO M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 576 CALLE CESAR GONZALEZ OFICINA 404
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City | SAN JUAN
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State | PR
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Zip | 00918-3756
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Country | US
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Telephone | 787-753-1097
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Fax | 787-764-3927
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Provider Business Mailing Address
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Address Line | F1-8 CALLE D MANSIONES DE VILLANOVA
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City | SAN JUAN
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State | PR
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Zip | 00926-6435
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Country | US
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Telephone | 787-731-5346
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13007
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License Number State | PR
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