Provider Demographics
NPI:1326003732
Name:MALDONADO, NEIL EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:EDWIN
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3881 HELMSMAN DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-0718
Mailing Address - Country:US
Mailing Address - Phone:239-649-3333
Mailing Address - Fax:239-529-6629
Practice Address - Street 1:400 8TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5519
Practice Address - Country:US
Practice Address - Phone:239-648-3333
Practice Address - Fax:239-529-6629
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL125555208D00000X
PR13328208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR600399OtherMEDICARE Y MUCHO MAS
PR6163OtherPREFERRED MEDICARE CHOICE
PR7328OtherAMERICAN HEALTH
PR6163OtherPREFERRED MEDICARE CHOICE
PR600399OtherMEDICARE Y MUCHO MAS
PR7328OtherAMERICAN HEALTH