Provider Demographics
NPI:1831169846
Name:CARDONA, HERNANDO A (MD)
Entity type:Individual
Prefix:
First Name:HERNANDO
Middle Name:A
Last Name:CARDONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 PARK CENTER DR
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5794
Mailing Address - Country:US
Mailing Address - Phone:407-704-6912
Mailing Address - Fax:407-704-6913
Practice Address - Street 1:1515 PARK CENTER DR
Practice Address - Street 2:SUITE 2D
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5794
Practice Address - Country:US
Practice Address - Phone:407-704-6912
Practice Address - Fax:407-704-6913
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 88235208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 88235OtherMEDICAL LICENSE