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General NPI Number Information
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NPI Number | 1215243829
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Entity Type | Individual
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Provider Name | NICOLE M CANDELARIO M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | PROFESSIONAL CENTER #2 LUIS MUNOZ RIVERA ST. SUITE 201
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-744-5353
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Fax | 787-961-1189
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Provider Business Mailing Address
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Address Line | P.O. BOX 1176
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-703-1525
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Fax | 787-703-1530
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 19349
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License Number State | PR
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