Healthcare Provider Details

I. General information

NPI: 1861304255
Provider Name (Legal Business Name): LETICIA DEL CARMEN ANGELINE CANCIO CARDONA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA MUNOZ RIVERA 53 OESTE BARRIO PUEBLO
CAMUY PR
00627-0094
US

IV. Provider business mailing address

PO BOX 94
CAMUY PR
00627-0094
US

V. Phone/Fax

Practice location:
  • Phone: 787-262-2221
  • Fax:
Mailing address:
  • Phone: 787-262-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16014
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: