1316946833 NPI number — MR. CARMELO E ZENO CARDONA MD, MS, CRP

Table of content: MR. CARMELO E ZENO CARDONA MD, MS, CRP (NPI 1316946833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316946833 NPI number — MR. CARMELO E ZENO CARDONA MD, MS, CRP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZENO CARDONA
Provider First Name:
CARMELO
Provider Middle Name:
E
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MS, CRP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316946833
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1296
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUEBRADILLAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00678-1296
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-895-4010
Provider Business Mailing Address Fax Number:
787-895-4010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
96 CALLE JOSE LINARES
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUEBRADILLAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00678-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-895-4010
Provider Business Practice Location Address Fax Number:
787-895-4010
Provider Enumeration Date:
07/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
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Authorized Official Title or Position:
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Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  7926 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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