Provider Demographics
NPI:1477513463
Name:CARDONA SILVA, MIGUEL H (OD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:H
Last Name:CARDONA SILVA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9386
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9386
Mailing Address - Country:US
Mailing Address - Phone:787-653-2275
Mailing Address - Fax:
Practice Address - Street 1:100 AVE SAN PATRICIO STE E13
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-2674
Practice Address - Country:US
Practice Address - Phone:787-793-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR414152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist