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General NPI Number Information
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NPI Number | 1093647513
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Entity Type | Individual
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Provider Name | SALI CORDERO AGPCNP-BC
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Gender |
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 1490 TOWN CENTER DR # N116
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City | LAKELAND
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State | FL
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Zip | 33803-7965
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Country | US
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Telephone | 863-904-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 1490 TOWN CENTER DR # N116
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City | LAKELAND
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State | FL
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Zip | 33803-7965
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11027178
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License Number State | FL
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