Healthcare Provider Details

I. General information

NPI: 1326577511
Provider Name (Legal Business Name): RIGOBERTO CORDERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 06/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7376 NW 35TH TER STE 103
MIAMI FL
33122-1241
US

IV. Provider business mailing address

7376 NW 35TH TER STE 103
MIAMI FL
33122-1241
US

V. Phone/Fax

Practice location:
  • Phone: 305-477-6750
  • Fax: 305-477-6750
Mailing address:
  • Phone: 305-477-6750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: