Provider Demographics
NPI:1245302603
Name:COLON MALDONADO, EVA LIZ (MD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:LIZ
Last Name:COLON MALDONADO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3269 CALLE MONTE LA MINA
Mailing Address - Street 2:URB. PRDERAS DEL RIO
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9132
Mailing Address - Country:US
Mailing Address - Phone:787-797-0754
Mailing Address - Fax:787-797-0754
Practice Address - Street 1:CARR.167 KM14.8 BO.BUENA VISTA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-797-0754
Practice Address - Fax:787-797-0754
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-03-22
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Provider Licenses
StateLicense IDTaxonomies
PR15664208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15664OtherLICENSE
I48074Medicare UPIN