Provider Demographics
NPI:1689122244
Name:CONCEPCION CARDONA, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CONCEPCION CARDONA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 CALLE FLAMBOYAN
Mailing Address - Street 2:URB LOS LLANOS
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-9676
Mailing Address - Country:US
Mailing Address - Phone:787-240-1118
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 2 KILOMETRO 45.8
Practice Address - Street 2:PLAZA MONTE REAL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-0007
Practice Address - Fax:787-854-6705
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist