MEDICARE: CAROLYN MALDONADO-GARCIA 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	207Q00000X	Family Medicine Physician	ME100021	FL
2	207R00000X	Internal Medicine Physician	ME100021	FL
3	208D00000X	General Practice Physician	ME100021	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669669578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN MALDONADO-GARCIA M.D.

Provider Business Mailing Address
First Line	:	4855 W HILLSBORO BLVD
Second Line	:	SUITE B-2
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-4356
Country	:	US
Telephone Number	:	954-418-1683
Fax Number	:	954-418-1698

Provider Business Practice Location Address
First Line	:	4020 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9416
Country	:	US
Telephone Number	:	855-226-6633
Fax Number	:	866-285-7068

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

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	01/21/2021

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