Provider Demographics
NPI:1720370430
Name:CARDONA, MARIA ISABEL (LND)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ISABEL
Last Name:CARDONA
Suffix:
Gender:F
Credentials:LND
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 831
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0831
Mailing Address - Country:US
Mailing Address - Phone:787-424-9778
Mailing Address - Fax:787-966-7260
Practice Address - Street 1:4 CALLE JOSE J ACOSTA
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4469
Practice Address - Country:US
Practice Address - Phone:787-807-3703
Practice Address - Fax:787-966-7260
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1446133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered