Provider Demographics
NPI:1215193321
Name:PEREZ MALDONADO, THAYRIN SILVETTE (DC)
Entity type:Individual
Prefix:DR
First Name:THAYRIN
Middle Name:SILVETTE
Last Name:PEREZ MALDONADO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G23 CALLE LUIS R PUMAREJO
Mailing Address - Street 2:EXT EL PRADO
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-306-5141
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM1.2
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor