Provider Demographics
NPI:1700088382
Name:CARDE, JORGE A (MA)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:A
Last Name:CARDE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:JORGE
Other - Middle Name:A
Other - Last Name:CARDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 270190
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-0190
Mailing Address - Country:US
Mailing Address - Phone:787-586-6887
Mailing Address - Fax:
Practice Address - Street 1:URB. CONDADO MODERNO 13 ST.
Practice Address - Street 2:M-31
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-703-4050
Practice Address - Fax:787-703-4115
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1770103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent