Provider Demographics
NPI:1508543471
Name:CARDONA, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 NW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9050 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-6569
Practice Address - Country:US
Practice Address - Phone:347-299-9618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9518191163WD1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal