Fidencio Maldonado Rios

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA15642 Issued in FL

Practice address

222 Arlington Loop
Haines City, FL 33844-5437

Phone

(863) 450-6469

NPI assigned

Mar 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1467039719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 ARLINGTON LOOP",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445437",
            "telephone_number": "863-450-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ARLINGTON LOOP",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445437",
            "telephone_number": "863-450-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO RIOS",
        "first_name": "FIDENCIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA15642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Maldonado.fidencio@yahoo.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "222 Arlington Loop",
            "city": "Haines City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338445437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Lubin
• Luv Thy Neighbor
• Jennea L Lyking, RN
• M-K of Haines City L L C
• Isidro Tucker Madrid Jr.
• Manuel G Jain, MD, LLC
• Makeia Keshon Martin
• Marisa Martin
• Flavia Martinez Acosta
• Clovis Airton Martins Braga Jr.

• Occupational Therapy Assistant in Haines City, FL
• Providers in Haines City, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.