Healthcare Provider Details

I. General information

NPI: 1609733880
Provider Name (Legal Business Name): CORVIA CARDIAC REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 CONROY WINDERMERE RD UNIT 161
WINDERMERE FL
34786-5007
US

IV. Provider business mailing address

9300 CONROY WINDERMERE RD UNIT 161
WINDERMERE FL
34786-5007
US

V. Phone/Fax

Practice location:
  • Phone: 689-224-7899
  • Fax:
Mailing address:
  • Phone: 689-224-7899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ADETOLUWA IJIDAKINRO
Title or Position: OWNER AND PHYSICIAN
Credential: MD
Phone: 407-900-8098