Provider Demographics
NPI:1275627234
Name:YOLANDA MALDONADO MALDONADO
Entity Type:Organization
Organization Name:YOLANDA MALDONADO MALDONADO
Other - Org Name:LABORATORIO CLINICO ALMENDROS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-785-1233
Mailing Address - Street 1:CC 35 CALLE CEIBA
Mailing Address - Street 2:RIO HONDO III
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3419
Mailing Address - Country:US
Mailing Address - Phone:787-785-1233
Mailing Address - Fax:787-780-2622
Practice Address - Street 1:CC 35 CALLE CEIBA
Practice Address - Street 2:RIO HONDO III
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3419
Practice Address - Country:US
Practice Address - Phone:787-785-1233
Practice Address - Fax:787-780-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR568291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3-0349OtherTRIPLE-S
6200024OtherHUMANA
8000209OtherMMM
7675OtherIMC
PR51018OtherCRUZ AZUL
1275627234OtherPROSSAM
7675OtherIMC
=========OtherTRICARE
6200024OtherHUMANA
=========OtherMAPFRE
=========OtherMCS
=========OtherTRICARE