Provider Demographics
NPI:1457983736
Name:CHARON CORDERO, JANIA M (MD)
Entity type:Individual
Prefix:DR
First Name:JANIA
Middle Name:M
Last Name:CHARON CORDERO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:CALLE 1 JARDIN DE ORQUIDEA
Mailing Address - Street 2:URB. JARDINES DE VEGA BAJA
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3965
Mailing Address - Country:US
Mailing Address - Phone:939-269-0170
Mailing Address - Fax:
Practice Address - Street 1:1 JADIN DE ORQUIDEA
Practice Address - Street 2:URB JARDINES
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3965
Practice Address - Country:US
Practice Address - Phone:939-269-0170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR22190208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR39973000Medicaid