Provider Demographics
NPI:1801414859
Name:SAADE MALDONADO, MARIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIEL
Middle Name:M
Last Name:SAADE MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6414
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00914-6414
Mailing Address - Country:US
Mailing Address - Phone:787-365-3537
Mailing Address - Fax:786-590-1651
Practice Address - Street 1:1451 AVE ASHFORD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1511
Practice Address - Country:US
Practice Address - Phone:787-721-2160
Practice Address - Fax:786-590-1651
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22499202D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine