Provider Demographics
NPI:1053306050
Name:RAMON MALDONADO. M.D.
Entity Type:Organization
Organization Name:RAMON MALDONADO. M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-247-9560
Mailing Address - Street 1:45 NE 9TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4611
Mailing Address - Country:US
Mailing Address - Phone:305-247-9560
Mailing Address - Fax:305-247-9561
Practice Address - Street 1:45 NE 9TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4611
Practice Address - Country:US
Practice Address - Phone:305-247-9560
Practice Address - Fax:305-247-9561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL217965OtherAVMED
FL32308OtherCIGNA
FL036571OtherNHP
FL113927OtherAMERIGROUP
FL32670OtherBC/BS
FLF94344OtherVISTA
FL217965OtherAVMED