MEDICARE: DR. ISMAEL MALDONADO TORRES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	8032	PR

General Provider Information

NPI Number	:	1174520605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISMAEL MALDONADO TORRES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 801425
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-1425
Country	:	US
Telephone Number	:	787-645-3405
Fax Number	:

Provider Business Practice Location Address
First Line	:	EUGENIO MARIA DE HOSTOS STREET #18
Second Line	:
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757
Country	:	US
Telephone Number	:	787-845-7492
Fax Number	:	787-845-4933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	06/22/2023

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