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General NPI Number Information
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NPI Number | 1841404225
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Entity Type | Organization
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Legal Business Name | LAB CLINICO CDT DR FERDINANDO MALDONADO
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | CARR. 129 KM 15.0 BO. BAYANEY
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City | HATILLO
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State | PR
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Zip | 00659
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Country | US
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Telephone | 787-820-1763
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Fax | 787-820-5759
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Provider Business Mailing Address
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Address Line | PO BOX BOX 9921 COTTO STATION
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City | ARECIBO
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State | PR
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Zip | 00613
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Country | US
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Telephone | 787-820-1763
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Fax | 787-820-5759
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Authorized Official
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Title or Position | MD
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Name | DR. FERDINANDO MALDONADO TERRON
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Credential | 9714
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Telephone | 787-820-1763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | PR
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