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General NPI Number Information
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NPI Number | 1376325951
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Entity Type | Individual
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Provider Name | GONZALO CARDONA
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Gender | Male
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 146 CALLE DEL PARQUE
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City | SAN JUAN
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State | PR
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Zip | 00911-1919
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Country | US
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Telephone | 787-722-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 146 CALLE DEL PARQUE
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City | SAN JUAN
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State | PR
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Zip | 00911-1919
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Country | US
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Telephone | 787-722-5422
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH-14740
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 966
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License Number State | PR
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