Provider Demographics
NPI:1992781520
Name:KAREH-CORDERO, PEDRO M (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:M
Last Name:KAREH-CORDERO
Suffix:
Gender:M
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:PO BOX 6317
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6317
Mailing Address - Country:US
Mailing Address - Phone:787-745-8515
Mailing Address - Fax:787-746-9044
Practice Address - Street 1:201 AVE GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MEDICAL PLAZA, SUITE 306
Practice Address - City:CAQUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-745-8515
Practice Address - Fax:787-746-9044
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRH7348207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
98801KAMedicare ID - Type Unspecified
C78254Medicare UPIN