Provider Demographics
NPI:1457554982
Name:MALDONADO, JOSE M (CLINICAL PSYCHOLOGIS)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:M
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:CLINICAL PSYCHOLOGIS
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Mailing Address - Street 1:PO BOX 8122
Mailing Address - Street 2:
Mailing Address - City:CAQUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8122
Mailing Address - Country:US
Mailing Address - Phone:787-237-3299
Mailing Address - Fax:787-745-0332
Practice Address - Street 1:AVE LUIS MUNOZ MARIN EDIFICIO MERCANTIL
Practice Address - Street 2:CORPORACION FONDO DEL SEQURO DEL ESTADO
Practice Address - City:CAQUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR687103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical