Provider Demographics
NPI:1346988714
Name:MATOS PIMENTEL, MADELINE MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:MARIA
Last Name:MATOS PIMENTEL
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:FOREST HILLS
Mailing Address - Street 2:D10 CALLE 22
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:939-402-2983
Mailing Address - Fax:
Practice Address - Street 1:FOREST HILLS
Practice Address - Street 2:D10 CALLE 22
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:939-402-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23738208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice