Provider Demographics
NPI:1639135742
Name:FERRES CORDERO, ANGEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:R
Last Name:FERRES CORDERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 CALLE URSULA CARDONA
Mailing Address - Street 2:URB LAS DELICIAS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-3918
Mailing Address - Country:US
Mailing Address - Phone:787-259-2318
Mailing Address - Fax:787-259-2318
Practice Address - Street 1:3224 URSULA CARDONA
Practice Address - Street 2:URB LAS DELICIAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-3918
Practice Address - Country:US
Practice Address - Phone:787-259-2318
Practice Address - Fax:787-259-2318
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5027207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE95917Medicare UPIN
PR0082521Medicare ID - Type Unspecified