Provider Demographics
NPI:1891510590
Name:MALDONADO, LINNETTE
Entity type:Individual
Prefix:
First Name:LINNETTE
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. COLINAS DEL PRADO
Mailing Address - Street 2:323 CALLE REINA ELIZABETH
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-2168
Mailing Address - Country:US
Mailing Address - Phone:787-616-5559
Mailing Address - Fax:
Practice Address - Street 1:URB. COLINAS DEL PRADO
Practice Address - Street 2:323 CALLE REINA ELIZABETH
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2168
Practice Address - Country:US
Practice Address - Phone:787-616-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1462224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant