Provider Demographics
NPI:1548764574
Name:CARDONA-MATOS, ZULMA (MD)
Entity type:Individual
Prefix:DR
First Name:ZULMA
Middle Name:
Last Name:CARDONA-MATOS
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:PMB 310 PO BOX 7891
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7891
Mailing Address - Country:US
Mailing Address - Phone:787-396-2464
Mailing Address - Fax:
Practice Address - Street 1:675 N SAINT CLAIR ST STE 14-100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5966
Practice Address - Country:US
Practice Address - Phone:312-695-7970
Practice Address - Fax:312-695-4433
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156705207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism