Healthcare Provider Details

I. General information

NPI: 1285858761
Provider Name (Legal Business Name): RAYZA CARIDAD CORDERO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SW 3RD AVE SUITE 1F
MIAMI FL
33129-2331
US

IV. Provider business mailing address

2721 SW 17TH AVE
MIAMI FL
33133-2524
US

V. Phone/Fax

Practice location:
  • Phone: 305-285-2574
  • Fax: 305-285-5505
Mailing address:
  • Phone: 305-854-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME98315
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: