Basic Information
| Provider Information | |||||||||
| NPI: | 1053577197 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORDONEZ | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | MMP UROLOGY | ||||||||
| Address2: | 100 BRICKHILL AVENUE | ||||||||
| City: | SOUTH PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077731728 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 BRICKHILL AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTH PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041061999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077731728 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2008 | ||||||||
| LastUpdateDate: | 07/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 57286 | MN | Y | Allopathic & Osteopathic Physicians | Urology | 208800000X | MD23852 | ME | N | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 1053577197 | 01 | MN | PREFERRED ONE | OTHER | 1053577197 | 01 | MN | HEALTHPARTNERS | OTHER | 57286 | 01 | MN | MINNESOTA MEDICAL LICENSE | OTHER |