Provider Demographics
NPI:1598405706
Name:CARDONA, JOEL JAVIER (DPM)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:JAVIER
Last Name:CARDONA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:
Other - Last Name:CARDONA VAZQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:1068 CRESTHAVEN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0809
Mailing Address - Country:US
Mailing Address - Phone:901-866-8864
Mailing Address - Fax:
Practice Address - Street 1:1068 CRESTHAVEN RD STE 110
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0845
Practice Address - Country:US
Practice Address - Phone:901-767-5620
Practice Address - Fax:901-763-4326
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN978213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery