Healthcare Provider Details

I. General information

NPI: 1487506747
Provider Name (Legal Business Name): MARIA CARDONA PATINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 RIO BRAVO BLVD SW
ALBUQUERQUE NM
87105-6057
US

IV. Provider business mailing address

13710 OAK RIDGE DR
DAVIE FL
33325-6515
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-0153
  • Fax:
Mailing address:
  • Phone: 954-548-1127
  • Fax: 954-548-1127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number88073
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number88073
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: