Provider Demographics
NPI:1831138817
Name:CARDE, PEDRO A (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:A
Last Name:CARDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:ANDREAS CT
Mailing Address - Street 2:370 CALLE 10 APARTADO 103
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-7804
Mailing Address - Country:US
Mailing Address - Phone:787-376-4909
Mailing Address - Fax:787-283-3854
Practice Address - Street 1:AVE GENERAL VALERO # 502
Practice Address - Street 2:TORRES HIMA SAN PABLO
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3949
Practice Address - Country:US
Practice Address - Phone:787-376-4909
Practice Address - Fax:787-283-3854
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12299207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0088643Medicare ID - Type Unspecified
PRG41287Medicare UPIN