Provider Demographics
NPI:1083762223
Name:PEREZCARDONA, NESTOR E (MD)
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:E
Last Name:PEREZCARDONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CALLE CARAZO
Mailing Address - Street 2:PO BOX 3768
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5717
Mailing Address - Country:US
Mailing Address - Phone:787-789-1940
Mailing Address - Fax:
Practice Address - Street 1:100 CALLE CARAZO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5717
Practice Address - Country:US
Practice Address - Phone:787-789-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8246208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice