Provider Demographics
NPI:1245913763
Name:MALDONADO, MELANIE SUE (CERTIFIED DOULA)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:SUE
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12850 W STATE ROAD 84 LOT 2-16
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3319
Mailing Address - Country:US
Mailing Address - Phone:954-709-4329
Mailing Address - Fax:
Practice Address - Street 1:12850 W STATE ROAD 84 LOT 2-16
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-3319
Practice Address - Country:US
Practice Address - Phone:954-709-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula