Provider Demographics
NPI:1376818120
Name:CARDONA, JOANNE (8438)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:8438
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C7 CALLE RUISENOR
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962-4513
Mailing Address - Country:US
Mailing Address - Phone:787-297-5170
Mailing Address - Fax:
Practice Address - Street 1:C7 CALLE RUISENOR
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-4513
Practice Address - Country:US
Practice Address - Phone:787-297-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8438183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician