Provider Demographics
NPI:1205964855
Name:CARDONA, LETICIA (RPH)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE ARISTIDES MAISONAVE
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-4832
Mailing Address - Country:US
Mailing Address - Phone:787-877-5022
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE ARISTIDES MAISONAVE
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist