Provider Demographics
NPI:1467953919
Name:CARDONA RUIZ, JOEL A (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:CARDONA RUIZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 COND ANDALUCIA APT 4402
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-2331
Mailing Address - Country:US
Mailing Address - Phone:787-240-7597
Mailing Address - Fax:
Practice Address - Street 1:76 CALLE UNION EDIFICIO JAIME RODRIGUEZ
Practice Address - Street 2:LOCAL A-1
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-585-9910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19849208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice