Provider Demographics
NPI:1104864693
Name:CARDENO, CORAZON N (MD)
Entity Type:Individual
Prefix:
First Name:CORAZON
Middle Name:N
Last Name:CARDENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORAZON
Other - Middle Name:CARDENO
Other - Last Name:ESPELETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24730
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202-4730
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4220 HARDING RD
Practice Address - Street 2:SUITE 500
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-222-6977
Practice Address - Fax:615-222-5322
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3857005OtherMEDICARE
H23857OtherHEALTHSPRING
TN3857007Medicaid
P00365729OtherRAILROAD MEDICARE
P00395837OtherRAILROAD MEDICARE
TN4137839OtherBLUE CROSS
KY7100007290OtherKENTUCKY MEDICAID
TN3857005Medicaid
2102564OtherFIRST HEALTH COVENTRY
TN4144468OtherBLUE CROSS
9682809OtherCIGNA
7117354OtherAETNA
P00395837OtherRAILROAD MEDICARE