MEDICARE: ERMELINDA CARDONA M.ED

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	101Y00000X	Counselor	MH19728	FL

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

General Provider Information

NPI Number	:	1558563742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERMELINDA CARDONA M.ED

Provider Business Mailing Address
First Line	:	1140 PAGE BLVD
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01104-1643
Country	:	US
Telephone Number	:	413-827-8959
Fax Number	:

Provider Business Practice Location Address
First Line	:	8803 VISTANA CENTRE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-6354
Country	:	US
Telephone Number	:	413-301-6019
Fax Number	:	413-363-2857

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

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	10/22/2022

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