Provider Demographics
NPI:1598410672
Name:CARDONA GONZALEZ, YOALIS (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:YOALIS
Middle Name:
Last Name:CARDONA GONZALEZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 9387
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-9722
Mailing Address - Country:US
Mailing Address - Phone:787-519-5590
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA INDUSTRIAL VICTOR ROJAS 2
Practice Address - Street 2:CARRETERA 129
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR76865367500000X
FL11017742367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered