Provider Demographics
NPI:1902673387
Name:CARDENAS HEALTHCARE GROUP INC
Entity Type:Organization
Organization Name:CARDENAS HEALTHCARE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANNET
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:ARPN
Authorized Official - Phone:786-387-0234
Mailing Address - Street 1:23503 SW 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6290
Mailing Address - Country:US
Mailing Address - Phone:786-387-0234
Mailing Address - Fax:
Practice Address - Street 1:23503 SW 108TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-6290
Practice Address - Country:US
Practice Address - Phone:786-387-0234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty