Myshanda Maldonado

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW15142 Issued in FL

Practice address

725 N 12TH Ave
Arcadia, FL 34266-8752

Phone

(863) 494-1242

Fax

(863) 491-0466

NPI assigned

Mar 4, 2018

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 23, 2018.

{
    "created_epoch": "1520121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1669974804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 12TH AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668752",
            "telephone_number": "863-494-1242",
            "fax_number": "863-491-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MYSHANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-04",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Edoardo Lubrano Heinsen, MD
• Cara Lukas
• Delton Eugene Lynch, DMD
• Mikael Mailloux-Kessler, MD
• Alyssa Herminia Maldonado
• Manatee Diagnostic Center, LTD
• Manatee Memorial Hospital LP
• Mark L. McClendon, PA
• Angela Martinez Zea, MS, RDN, LDN
• Tamara Martinez-Morales, PH.D.

• All providers in Arcadia, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.