Provider Demographics
NPI:1447298534
Name:DELGADO-CARDONA, IRIS Y (MD)
Entity type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:Y
Last Name:DELGADO-CARDONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0204
Mailing Address - Country:US
Mailing Address - Phone:787-896-1865
Mailing Address - Fax:787-896-1865
Practice Address - Street 1:19 CALLE ANDRES MENDEZ LICIAGA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2222
Practice Address - Country:US
Practice Address - Phone:787-896-1865
Practice Address - Fax:787-896-1865
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14091208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9032OtherINTERNATIONAL MEDICAL CAR
PR00121718OtherHUMANA
PR9953OtherCRUZ AZUL
PR201997OtherPREFERRED HEALTH
PR00121718OtherHUMANA
PRH55673Medicare UPIN