Provider Demographics
NPI:1215574512
Name:CORDERO, MARIA DEL CARMEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:CORDERO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 159 AVE ESMERALDA 405 STE 2
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-342-4663
Mailing Address - Fax:
Practice Address - Street 1:2550 AVE DE DIEGO
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-4800
Practice Address - Country:US
Practice Address - Phone:787-762-8412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist