MEDICARE: DAVID CORDERO CRNA

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9200103	FL
2	367500000X	Certified Registered Nurse Anesthetist	ANT9200103	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720217706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CORDERO CRNA

Provider Business Mailing Address
First Line	:	1613 HARRISON PKWY STE 200
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2853
Country	:	US
Telephone Number	:	800-437-2672
Fax Number	:

Provider Business Practice Location Address
First Line	:	2332 GALIANO ST # 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5402
Country	:	US
Telephone Number	:	786-464-5496
Fax Number	:

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

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	04/10/2025

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