MEDICARE: DR. JENNIFER MARIE ALSINA CARDONA O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	002660	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260060	OTHER	CT	CONNECTICARE

General Provider Information

NPI Number	:	1003995440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER MARIE ALSINA CARDONA O.D.

Provider Business Mailing Address
First Line	:	271 SIERRA MORENA
Second Line	:	LA CUMBRE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5539
Country	:	US
Telephone Number	:	787-708-5838
Fax Number	:

Provider Business Practice Location Address
First Line	:	271 CALLE SIERRA MORENA
Second Line	:	LA CUMBRE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5539
Country	:	US
Telephone Number	:	787-708-5838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2006
Last Update Date	:	12/18/2009

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