Provider Demographics
NPI:1235339367
Name:MALDONADO, AMARILYS (MD)
Entity Type:Individual
Prefix:DR
First Name:AMARILYS
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9446
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-0446
Mailing Address - Country:US
Mailing Address - Phone:787-746-1688
Mailing Address - Fax:787-731-4643
Practice Address - Street 1:AVE LUIS MUNOZ MARIN
Practice Address - Street 2:SUITE 202
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-4081
Practice Address - Country:US
Practice Address - Phone:787-746-1688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR107712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology