MEDICARE: SALI CORDERO AGPCNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	11027178	FL

General Provider Information

NPI Number	:	1093647513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALI CORDERO AGPCNP-BC

Provider Business Mailing Address
First Line	:	1490 TOWN CENTER DR # N116
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-7965
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1490 TOWN CENTER DR # N116
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-7965
Country	:	US
Telephone Number	:	863-904-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ SALI CORDERO AGPCNP-BC” Practice Location

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