Provider Demographics
NPI:1467477984
Name:MALDONADO, MARIA ELISA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ELISA
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G32 LA SANTA COLINAS METROPOLITANAS
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5211
Mailing Address - Country:US
Mailing Address - Phone:787-449-2842
Mailing Address - Fax:
Practice Address - Street 1:G32 LA SANTA COLINAS METROPOLITANAS
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5211
Practice Address - Country:US
Practice Address - Phone:787-449-2842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2122103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical