Provider Demographics
NPI:1194867309
Name:MALDONADO, FELIX (DDS)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE ZARZUELA SE-35
Mailing Address - Street 2:MANSION DEL SUR
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-785-2061
Mailing Address - Fax:787-785-2061
Practice Address - Street 1:CALLE 78 BLOQUE 92 #3 FRENTE PARQUE DE LAS CIENCIAS
Practice Address - Street 2:SIERRA BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-785-2061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice