Provider Demographics
NPI:1295436319
Name:MALDONADO MENDEZ, JOSE JULIAN
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:JULIAN
Last Name:MALDONADO MENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:D79 CALLE ALCAZAR
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7313
Mailing Address - Country:US
Mailing Address - Phone:787-371-9097
Mailing Address - Fax:
Practice Address - Street 1:BARRIO MONACILLOS SAN JUAN PR
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-754-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program