Provider Demographics
NPI:1003995440
Name:ALSINA CARDONA, JENNIFER MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:ALSINA CARDONA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 SIERRA MORENA
Mailing Address - Street 2:LA CUMBRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5539
Mailing Address - Country:US
Mailing Address - Phone:787-708-5838
Mailing Address - Fax:
Practice Address - Street 1:271 CALLE SIERRA MORENA
Practice Address - Street 2:LA CUMBRE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5539
Practice Address - Country:US
Practice Address - Phone:787-708-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002660152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT260060OtherCONNECTICARE