Provider Demographics
NPI:1891911293
Name:CARDONA-HERNANDEZ, BLANCA (MD)
Entity Type:Individual
Prefix:DR
First Name:BLANCA
Middle Name:
Last Name:CARDONA-HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 CALLE BENITO FEIJOO
Mailing Address - Street 2:EL SENORIAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6954
Mailing Address - Country:US
Mailing Address - Phone:787-761-2577
Mailing Address - Fax:787-767-3968
Practice Address - Street 1:BO MONCILLO
Practice Address - Street 2:HOSPITAL INDUSTRIAL-CENTRO MEDICO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-754-2525
Practice Address - Fax:787-767-3968
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3437208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3437OtherSTATE LICENSE