Individual
MR. IVAN RENE CARDONA CAMPOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1409 FERIA STREET, SANTURCE, PR 00909
(787) 723-4403
(787) 723-4403
Mailing address
PO BOX 19780, SAN JUAN, PR 00910-9780
(787) 723-5553
(787) 723-4403
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
3032
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2453
PMC
PR
01
—
600024
MMM
PR
01
—
H264
FIRST MEDICAL
PR
Enumeration date
11/13/2006
Last updated
07/08/2007
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