Healthcare Provider Details
I. General information
NPI: 1548434061
Provider Name (Legal Business Name): YVETTE C CORDOVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/15/2008
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 NW 9TH AVE STE 201
MIAMI FL
33136-1101
US
IV. Provider business mailing address
1801 NW 9TH AVE STE 201
MIAMI FL
33136-1101
US
V. Phone/Fax
- Phone: 786-466-8444
- Fax: 305-573-6537
- Phone: 786-466-8444
- Fax: 305-573-6537
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | ME123870 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | ME123870 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: