Provider Demographics
NPI:1881482156
Name:DE CARDENAS, MICHAEL RAUL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAUL
Last Name:DE CARDENAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9225 SW 90TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2003
Mailing Address - Country:US
Mailing Address - Phone:305-298-3710
Mailing Address - Fax:305-587-2711
Practice Address - Street 1:9225 SW 90TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2003
Practice Address - Country:US
Practice Address - Phone:305-330-3415
Practice Address - Fax:305-587-2711
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies