Provider Demographics
NPI:1003851791
Name:ORLANDO MALDONADO, MD, PA
Entity Type:Organization
Organization Name:ORLANDO MALDONADO, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-749-7997
Mailing Address - Street 1:407 6TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1927
Mailing Address - Country:US
Mailing Address - Phone:941-749-7997
Mailing Address - Fax:
Practice Address - Street 1:407 6TH AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1927
Practice Address - Country:US
Practice Address - Phone:941-749-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3123Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER