Coralia Krystal Maldonado

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

005945 Issued in PR

Practice address

Carr. 833 KM 12.2 Santa Rosa III
Guaynabo, PR 00961

Phone

(787) 435-2321

NPI assigned

Oct 9, 2019

Last updated

Mar 14, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Alternative Life LLC

  • Clinical Psychologist
  • Guaynabo, PR
  • NPI 1083383152
  NPD Authorized official

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1295377430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB VILLA ESPANA",
            "address_2": "LAS MERCEDES P 58",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 833 KM 12.2 SANTA ROSA III",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-435-2321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Urb Villa Espana",
            "address_2": "Las Mercedes P 58",
            "address_purpose": "LOCATION",
            "city": "Bayamon",
            "state": "PR",
            "postal_code": "00961",
            "country_code": "US",
            "telephone_number": "787-435-2321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "CORALIA",
        "middle_name": "KRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "005945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Maldonado Rodriguez, 0520P
• Francisco Maldonado Seda, 1460B
• Jose Rafael Maldonado Soler, MD COUNSELING PSYC
• Jorge Maldonado Velazquez, 1888P
• Ivelisse J. Maldonado-Morales, PSY. D.
• Hector Ignacio Maldonado, M.D.
• Karla Michelle Maldonado, D.M.D.
• Laura Desiree Maldonado
• Mara Maldonado, DMD
• Maria Elisa Maldonado, PSYD

• Clinical Psychologist in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.