Provider Demographics
NPI:1417951955
Name:MALDONADO, HECTOR IGNACIO (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:IGNACIO
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1214 AVE MAGDALENA
Mailing Address - Street 2:COND. EL PLAZA APT. 6
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1713
Mailing Address - Country:US
Mailing Address - Phone:787-720-8194
Mailing Address - Fax:787-720-8194
Practice Address - Street 1:AVE. APOLO ESQ. ALEJANDRINO
Practice Address - Street 2:(ALTOS FCIA. LUIS)
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-720-8194
Practice Address - Fax:787-720-8194
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7695207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD26756Medicare UPIN
PR99359Medicare ID - Type Unspecified