Basic Information
Provider Information
NPI: 1457429847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIGUEROA MALDONADO
FirstName: ADELIZ
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AUDILOGIST
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 193069
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009193069
CountryCode: US
TelephoneNumber: 7877610036
FaxNumber: 7872925050
Practice Location
Address1: URB BARALT I 20
Address2:  
City: FAJARDO
State: PR
PostalCode: 00738
CountryCode: US
TelephoneNumber: 7878604233
FaxNumber: 7872925050
Other Information
ProviderEnumerationDate: 12/01/2006
LastUpdateDate: 01/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X0584PRY193400000X SINGLE SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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