MEDICARE: DR. JOSYMAR CARDONA PH.D.

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	103TC0700X	Clinical Psychologist	2532	PR

General Provider Information

NPI Number	:	1841434750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSYMAR CARDONA PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 10663
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00922-0663
Country	:	US
Telephone Number	:	787-599-0123
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 AVE EMILIANO POL
Second Line	:	URB. LA CUMBRE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5539
Country	:	US
Telephone Number	:	787-599-0123
Fax Number	:

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

Provider Enumeration Date	:	04/22/2009
Last Update Date	:	04/22/2009

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