Provider Demographics
NPI:1932809258
Name:MALDONADO, HEATHER ANN (RN, CRNA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 NW 56TH DR APT 113
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3131
Mailing Address - Country:US
Mailing Address - Phone:954-793-3273
Mailing Address - Fax:
Practice Address - Street 1:21644 STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1842
Practice Address - Country:US
Practice Address - Phone:954-793-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9290649163WC0200X
FLAPRN11040024367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine