Provider Demographics
NPI:1457383259
Name:ZALDUONDO, FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:ZALDUONDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 AVE MARGINAL KENNEDY
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-1746
Mailing Address - Country:US
Mailing Address - Phone:787-620-5757
Mailing Address - Fax:787-905-7921
Practice Address - Street 1:280 AVE MARGINAL KENNEDY
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-1746
Practice Address - Country:US
Practice Address - Phone:787-620-5757
Practice Address - Fax:787-905-7921
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12263174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0089350Medicare UPIN
PR0088509Medicare UPIN
PR0089684AMedicare UPIN