Provider Demographics
NPI:1770893794
Name:MALDONADO, EIMER (PHARMACY DOCTOR)
Entity type:Individual
Prefix:
First Name:EIMER
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:PHARMACY DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-0102
Mailing Address - Country:US
Mailing Address - Phone:787-430-2867
Mailing Address - Fax:
Practice Address - Street 1:CARR 150 KM 1 H5
Practice Address - Street 2:BO CAMARONES SECTOR LOS ROBLES
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766
Practice Address - Country:US
Practice Address - Phone:787-812-5980
Practice Address - Fax:787-812-5966
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR53521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist