Provider Demographics
NPI:1841404225
Name:LAB CLINICO CDT DR FERDINANDO MALDONADO
Entity Type:Organization
Organization Name:LAB CLINICO CDT DR FERDINANDO MALDONADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINANDO
Authorized Official - Middle Name:MALDONADO
Authorized Official - Last Name:TERRON
Authorized Official - Suffix:
Authorized Official - Credentials:9714
Authorized Official - Phone:787-820-1763
Mailing Address - Street 1:PO BOX BOX 9921 COTTO STATION
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613
Mailing Address - Country:US
Mailing Address - Phone:787-820-1763
Mailing Address - Fax:787-820-5759
Practice Address - Street 1:CARR. 129 KM 15.0
Practice Address - Street 2:BO. BAYANEY
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-820-1763
Practice Address - Fax:787-820-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory