Lady Judith Maldonado, M.A.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5481 Issued in PR

Practice address

Santa Maria Medical Building Calle Ferrocamll 450
Suite 203
Ponce, PR 00717-1105

Phone

(787) 984-2019

Fax

(787) 984-2019

NPI assigned

Jul 7, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144742560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10278",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007320278",
            "telephone_number": "787-638-3788",
            "fax_number": "787-984-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SANTA MARIA MEDICAL BUILDING CALLE FERROCAMLL 450",
            "address_2": "SUITE 203",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171105",
            "telephone_number": "787-984-2019",
            "fax_number": "787-984-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "LADY",
        "middle_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": "5481",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "5481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enid Marie Maldonado, PHARM.D.
• Felix Maldonado, M.D.
• Giselle Marie Maldonado, LIC. OPTICO
• Gretchen Lorraine Maldonado
• Karla Michelle Maldonado
• Licelott Marie Maldonado, CLIN. PSYCHOLOGIST
• Nahil Maldonado, MD
• Natalie Maldonado
• Viveca Maldonado, OD
• Zilkia Enid Maldonado

• Psychologist in Ponce, PR
• Providers in Ponce, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.