Provider Demographics
NPI:1275702243
Name:MALDONADO MALDONADO, YOLANDA (MT)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:MALDONADO MALDONADO
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:LABORATORIO
Other - Middle Name:CLINICO
Other - Last Name:ALMENDROS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1665247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR660397575OtherCIGNA
PR660397575OtherTRICARE
PR51018OtherCRUZ AZUL DE PR
PR30349OtherTRIPLE-S
PR6200024OtherHUMANA
PR660397575OtherMCS
PR660397575OtherUHC
PR7675OtherIMC
PR8000209OtherMMM
PR660397575OtherMAPFRE
PR1275627234OtherPROSSAM
PR660397575OtherUHC