Organization
LORETTO MALDONADO, PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORETTO MALDONADO PHD (PRESIDENT)
(561) 367-9997
Entity
Organization
Contact information
Practice address
398 CAMINO GARDENS BLVD, SUITE 207, BOCA RATON, FL 33432-5827
(561) 367-9997
(561) 391-3574
Mailing address
398 CAMINO GARDENS BLVD, SUITE 207, BOCA RATON, FL 33432-5827
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY0003787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73205
MEDICARE
FL
Enumeration date
06/06/2011
Last updated
06/06/2011
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