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General NPI Number Information
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NPI Number | 1174822761
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Entity Type | Individual
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Provider Name | MR. CORDELL DAY
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Gender | Male
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 2700 WESTHALL LN STE 3207
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City | MAITLAND
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State | FL
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Zip | 32751-7203
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Country | US
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Telephone | 800-840-2528
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 FAY BLVD
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City | COCOA
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State | FL
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Zip | 32927-8569
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Country | US
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Telephone | 313-675-7593
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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