Provider Demographics
NPI:1477755403
Name:MALDONADO MARIN, JUAN FRANCISCO (OTR)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:FRANCISCO
Last Name:MALDONADO MARIN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARK GARDENS
Mailing Address - Street 2:A-16 MARACAIBO STREET
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2203
Mailing Address - Country:US
Mailing Address - Phone:787-761-5842
Mailing Address - Fax:
Practice Address - Street 1:PARK GARDENS
Practice Address - Street 2:A-16 MARACAIBO STREET
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2203
Practice Address - Country:US
Practice Address - Phone:787-761-5842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR634225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist