Provider Demographics
NPI:1194806943
Name:CARDENTEY, JOSE (AP)
Entity type:Individual
Prefix:PROF
First Name:JOSE
Middle Name:
Last Name:CARDENTEY
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 SW 97TH RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4069
Mailing Address - Country:US
Mailing Address - Phone:786-859-6216
Mailing Address - Fax:305-222-6199
Practice Address - Street 1:6303 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4825
Practice Address - Country:US
Practice Address - Phone:305-661-4989
Practice Address - Fax:305-222-6199
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1171171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP1171OtherLICENSE
FL262152079OtherTX ID