Provider Demographics
NPI:1518373059
Name:ALMONTE, MADELYN (PA-C)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:ALMONTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1503 ORCHARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-5709
Mailing Address - Country:US
Mailing Address - Phone:706-812-6131
Mailing Address - Fax:706-882-3982
Practice Address - Street 1:1503 ORCHARD HILL RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-5709
Practice Address - Country:US
Practice Address - Phone:706-812-6131
Practice Address - Fax:706-882-3982
Is Sole Proprietor?:No
Enumeration Date:2014-07-04
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA007102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant