MEDICARE: DR. FERNANDO YOMAR CORDERO-BAEZ MD

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	207R00000X	Internal Medicine Physician	ME167330	FL
2	207R00000X	Internal Medicine Physician	MT222824	PA
3	207RI0200X	Infectious Disease Physician	ME167330	FL

General Provider Information

NPI Number	:	1679138424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERNANDO YOMAR CORDERO-BAEZ MD

Provider Business Mailing Address
First Line	:	4710 N HABANA AVE STE 200
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7146
Country	:	US
Telephone Number	:	813-450-3457
Fax Number	:	877-235-3648

Provider Business Practice Location Address
First Line	:	4710 N HABANA AVE STE 200
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7146
Country	:	US
Telephone Number	:	813-450-3457
Fax Number	:

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

Provider Enumeration Date	:	05/07/2019
Last Update Date	:	06/08/2026

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