Provider Demographics
NPI:1093000754
Name:CARDONA, ARIEL COLON
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:COLON
Last Name:CARDONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXT.LA CARMEN A-9 CALLE 6,BOX 621
Mailing Address - Street 2:BOX 621
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS #997 AVE FAGOT 1 SUITE
Practice Address - Street 2:1 AVE.FAGOT
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731-3721
Practice Address - Country:US
Practice Address - Phone:787-841-2135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist