Provider Demographics
NPI:1205678810
Name:MALDONADO, KIARA NAIOMY
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:NAIOMY
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC01 BOX 4922
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664-9710
Mailing Address - Country:US
Mailing Address - Phone:787-242-7185
Mailing Address - Fax:
Practice Address - Street 1:HC01 BOX 4922
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-9710
Practice Address - Country:US
Practice Address - Phone:787-242-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program