MEDICARE: MR. ROLANDO C CADENA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	234	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	NM005397	OTHER	NM	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1497744288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROLANDO C CADENA DPM

Provider Business Mailing Address
First Line	:	2930 HILLRISE DR
Second Line	:	STE4
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4776
Country	:	US
Telephone Number	:	575-522-3330
Fax Number	:	575-522-7853

Provider Business Practice Location Address
First Line	:	2930 HILLRISE DR
Second Line	:	STE4
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4776
Country	:	US
Telephone Number	:	575-522-3330
Fax Number	:	575-522-7853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	07/10/2009

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