Healthcare Provider Details

I. General information

NPI: 1609668201
Provider Name (Legal Business Name): STEVEN CORDOVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 09/14/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 CALLE SERGIO PENA ALMODOVAR #163
HUMACAO PR
00791
US

IV. Provider business mailing address

3219 SW 27TH ST
MIAMI FL
33133-2813
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-0665
  • Fax:
Mailing address:
  • Phone: 915-309-2460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number025073
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: