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NPI Code Detail

MEDICARE: JONATHAN CORDOVA

MEDICARE: JONATHAN CORDOVA
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
13747P1801XPersonal Care Attendant
2372500000XChore Provider
3372600000XAdult Companion
43747A0650XAttendant Care Provider
5376J00000XHomemaker

General Provider Information

NPI Number : 1215703731
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN CORDOVA
Provider Business Mailing Address
First Line : 4455 S JONES BLVD STE 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3365
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4455 S JONES BLVD STE 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3365
Country : US
Telephone Number : 702-485-4838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2023
Last Update Date : 11/27/2023

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Directions to “ JONATHAN CORDOVA ” Practice Location

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