Malfryn Domingo Calderon

Individual provider Active NPI Physician Assistant · Caguas, PR

NPI 1043084742 · NPPES record last updated Nov 14, 2023

Key facts

NPI
1043084742
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
1487PA (PR)
Practice address
Reparto Caguax
Calle Colesibi Q16
Caguas, PR 00725
Phone
(787) 718-0265
NPI assigned
Nov 13, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1487PAPRMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1487PA PR Yes

Addresses

Primary practice location

Reparto Caguax
Calle Colesibi Q16
Caguas, PR 00725

Mailing address

Q18 Calle Colesibi
Caguas, PR 00725-3329
Phone (787) 718-0265

Other providers in Caguas, PR

All providers in Caguas, PR · Physician Assistant in Puerto Rico

Sources for this page

Verify at the official NPI Registry.