Healthcare Provider Details

I. General information

NPI: 1548764574
Provider Name (Legal Business Name): ZULMA CARDONA-MATOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 CALLE PAVIA STE 108
SAN JUAN PR
00909-2241
US

IV. Provider business mailing address

PO BOX 8910
SAN JUAN PR
00910-0910
US

V. Phone/Fax

Practice location:
  • Phone: 787-726-9090
  • Fax:
Mailing address:
  • Phone: 872-360-5427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number24859
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: