Provider Demographics
NPI:1013212166
Name:ANABELLE MALDONADO-MEDINA M.D P A
Entity Type:Organization
Organization Name:ANABELLE MALDONADO-MEDINA M.D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:DR
Authorized Official - First Name:ANABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO-MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-836-5053
Mailing Address - Street 1:9999 NE 2ND AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2345
Mailing Address - Country:US
Mailing Address - Phone:305-836-5053
Mailing Address - Fax:305-836-9727
Practice Address - Street 1:9999 NE 2ND AVE STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138
Practice Address - Country:US
Practice Address - Phone:305-836-5053
Practice Address - Fax:305-836-9727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049821174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty