Provider Demographics
NPI:1841683521
Name:MALDONADO, MARITZA (ED D)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FLAMINGO APARTMENTS APT 10302
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-4364
Mailing Address - Country:US
Mailing Address - Phone:787-399-4419
Mailing Address - Fax:
Practice Address - Street 1:10 FLAMINGO APARTMENTS APT 10302
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-4364
Practice Address - Country:US
Practice Address - Phone:787-399-4419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist