Provider Demographics
NPI:1417262569
Name:CARDENAS, COLOMBIA VANESSA (MD)
Entity Type:Individual
Prefix:DR
First Name:COLOMBIA
Middle Name:VANESSA
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:CARDENAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3750 E VIA PALOMITA APT 11203
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718
Mailing Address - Country:US
Mailing Address - Phone:561-305-3390
Mailing Address - Fax:
Practice Address - Street 1:2800 AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713
Practice Address - Country:US
Practice Address - Phone:520-626-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist