Provider Demographics
NPI:1770688541
Name:MALDONADO TRINIDAD, FELIX
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:
Last Name:MALDONADO TRINIDAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2DA AVE LOS ROSALES
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-862-4124
Mailing Address - Fax:
Practice Address - Street 1:2DA AVE 5 LOS ROSALES
Practice Address - Street 2:MANATI
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-862-4124
Practice Address - Fax:787-862-3532
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8431208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0011017OtherHUMANA GOBIERNO
PR29423OtherTRIPLE SSS, INC
PR999365OtherPREFERRED MEDICARE CHOISE
PR063206OtherCRUZ AZUL
PRN231OtherINTERNATIONAL MEDICAL CAR
PR117552OtherACAA
PR2011510OtherPREFERRED HEALTH
PR999365OtherPREFERRED MEDICARE CHOISE
PRC79206Medicare UPIN