Individual provider Active NPI

Anthony John Maldonado, PHARM.D.

  • Pharmacist
  • Sanford, FL
National Provider Identifier
1295308021
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS54504 Issued in FL
Practice address
2921 S Orlando Dr Ste 130
Sanford, FL 32773-4106
Phone
(855) 283-6679
Fax
(407) 878-3106
NPI assigned
Jul 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS54504 FL Primary

Addresses

Primary practice location

2921 S Orlando Dr Ste 130
Sanford, FL 32773-4106

Mailing address

140 Roberta Rd
Ormond Beach, FL 32176-3220
Phone (646) 202-3418

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS54504FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bueno Clinic Current Accepting new patients
Bueno Pharmacy LLC Current Accepting new patients
Bueno Pharmacy LLC Current Accepting new patients

Locations

2921 S Orlando Dr
Ste 130
Sanford, FL 32773
Phone (321) 285-9907

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1295308021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROBERTA RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321763220",
            "telephone_number": "646-202-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 S ORLANDO DR STE 130",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327734106",
            "telephone_number": "855-283-6679",
            "fax_number": "407-878-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.