Individual provider Active NPI

David G Latoni Maldonado, M.D.

  • Dermatology Physician
  • San Juan, PR
National Provider Identifier
1609911213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
8764 Issued in PR
Practice address
611 Calle Dr Pavia Fernandez Ste 101
San Juan, PR 00909-2240
Phone
(787) 268-1110
Fax
(787) 726-6246
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 8764 PR Primary

Addresses

Primary practice location

611 Calle Dr Pavia Fernandez Ste 101
San Juan, PR 00909-2240

Mailing address

611 Calle Dr Pavia Fernandez Ste 101
San Juan, PR 00909-2240
Phone (787) 268-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070518000411 PR Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 0446357826 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609911213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 CALLE DR PAVIA FERNANDEZ STE 101",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092240",
            "telephone_number": "787-268-1110",
            "fax_number": "787-726-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CALLE DR PAVIA FERNANDEZ STE 101",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092240",
            "telephone_number": "787-268-1110",
            "fax_number": "787-726-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATONI MALDONADO",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "8764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.