Provider Demographics
NPI:1083829220
Name:ALDAHONDO, OTTO L (MD)
Entity type:Individual
Prefix:DR
First Name:OTTO
Middle Name:L
Last Name:ALDAHONDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14501 AUDUBON TRCE APT 719
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-5410
Mailing Address - Country:US
Mailing Address - Phone:787-309-1123
Mailing Address - Fax:458-200-3414
Practice Address - Street 1:258 CALLE SAN JORGE
Practice Address - Street 2:SAN JORGE MEDICAL BUILDING SUITE 205
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-727-1000
Practice Address - Fax:787-727-6550
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2022-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR16740208000000X, 2080S0012X
FLME140868208000000X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics