| Doctor Name: | DR. AGNES ILEANA CARDONA |
| NPI Number: | 1043420433 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 12354 |
| Business Practice Address: | Cfse Urb. Cordova Davila Carr. #2 Interior Manati, PR - 00674 |
| Business Phone Number: | 7878542495 |
| Business Fax Number: | 7878844009 |
| Mailing Address: | Nuevas Villas Del Manati Ave. Las Palmas Aptdo 250, MANATI |
| State: | PR |
| Postal Code: | 00674 |
| Phone Number: | 7878845586 |
| Fax Number: | |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 12354 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |