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General NPI Number Information
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NPI Number | 1013135219
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Entity Type | Individual
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Provider Name | DR. MARIA L CORDOVA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 1324 CALLE CANADA ANTIGUOHOSPITAL VETRANO PUERTO NUEVO
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City | SAN JUAN
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State | PR
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Zip | 00920-3860
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Country | US
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Telephone | 787-793-1554
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Fax |
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Provider Business Mailing Address
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Address Line | 1971 CALLE SANDALO SAN RAMON
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City | GUAYNABO
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State | PR
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Zip | 00969-3940
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 11245
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License Number State | PR
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