Provider Demographics
NPI:1245638535
Name:MALDONADO, MILAGROS R (LMHC)
Entity type:Individual
Prefix:
First Name:MILAGROS
Middle Name:R
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11367 SW 248TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3442
Mailing Address - Country:US
Mailing Address - Phone:786-592-0057
Mailing Address - Fax:
Practice Address - Street 1:4343 W FLAGLER ST STE 503
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1585
Practice Address - Country:US
Practice Address - Phone:305-374-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-18
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH12835Medicaid