1457983736 NPI number — DR. JANIA M CHARON CORDERO MD

Table of content: DR. JANIA M CHARON CORDERO MD (NPI 1457983736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457983736 NPI number — DR. JANIA M CHARON CORDERO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHARON CORDERO
Provider First Name:
JANIA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1457983736
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE 1 JARDIN DE ORQUIDEA
Provider Second Line Business Mailing Address:
URB. JARDINES DE VEGA BAJA
Provider Business Mailing Address City Name:
VEGA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00693-3965
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-269-0170
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 JADIN DE ORQUIDEA
Provider Second Line Business Practice Location Address:
URB JARDINES
Provider Business Practice Location Address City Name:
VEGA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00693-3965
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-269-0170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  22190 , 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)

  • Identifier: 39973000 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com