Basic Information
| Provider Information | |||||||||
| NPI: | 1083829220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALDAHONDO | ||||||||
| FirstName: | OTTO | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14501 AUDUBON TRCE APT 719 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336135410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873091123 | ||||||||
| FaxNumber: | 4582003414 | ||||||||
| Practice Location | |||||||||
| Address1: | 258 CALLE SAN JORGE | ||||||||
| Address2: | SAN JORGE MEDICAL BUILDING SUITE 205 | ||||||||
| City: | SANTURCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877271000 | ||||||||
| FaxNumber: | 7877276550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2007 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 16740 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | ME140868 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080S0012X | 16740 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | Sleep Medicine | 2080S0012X | ME140868 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | Sleep Medicine |
No ID Information.