Provider Demographics
NPI:1467618926
Name:CARDONA, ANNABELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNABELLE
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:CARDONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:236 W 6TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4517
Mailing Address - Country:US
Mailing Address - Phone:775-322-4061
Mailing Address - Fax:775-322-6603
Practice Address - Street 1:236 W 6TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4517
Practice Address - Country:US
Practice Address - Phone:775-322-4061
Practice Address - Fax:775-322-6603
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003535A152W00000X
OR3290AT152W00000X
NV651152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist