Provider Demographics
NPI:1639399785
Name:MALDONADO, JANET AILEEN (RPH)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:AILEEN
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET 681 ISLOTE
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613
Mailing Address - Country:US
Mailing Address - Phone:787-879-1862
Mailing Address - Fax:787-879-1862
Practice Address - Street 1:ROAD 129 HOSP METROPOLITANO CAYETANO COLL Y TOSTE
Practice Address - Street 2:AVE ROTARIO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-650-7280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist