Provider Demographics
NPI:1467649905
Name:MALDONADO SANTOS, CARLOS I (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:I
Last Name:MALDONADO SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:I
Other - Last Name:MALDONADO SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:MEDICAL OPHTHALMIC PLAZA SUITE 101
Mailing Address - Street 2:CARR. #2 KM. 11.9
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-787-0250
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL OPHTHALMIC PLAZA SUITE 101
Practice Address - Street 2:CARR. #2 KM. 11.9
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-787-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR182692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry