Provider Demographics
NPI:1982784112
Name:MALDONADO TERRON, FERDINANDO (9714)
Entity Type:Individual
Prefix:DR
First Name:FERDINANDO
Middle Name:
Last Name:MALDONADO TERRON
Suffix:
Gender:M
Credentials:9714
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 9921 COTTO STATION
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9921
Mailing Address - Country:US
Mailing Address - Phone:787-820-1763
Mailing Address - Fax:787-820-5759
Practice Address - Street 1:CARR. 129 K.M. 15.1
Practice Address - Street 2:BARRIO BAYANEY
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-820-1763
Practice Address - Fax:787-820-5759
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9714208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE81958Medicare UPIN