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General NPI Number Information
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NPI Number | 1902263304
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Entity Type | Organization
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Legal Business Name | NORMA B. CORNEJO, M.D.P.A.
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 215 WESTWARD DR
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5259
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Country | US
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Telephone | 305-885-1792
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Fax |
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Provider Business Mailing Address
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Address Line | 215 WESTWARD DR
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5259
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Country | US
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Telephone | 305-885-1792
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NORMA B CORNEJO
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Credential | M.D.
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Telephone | 305-885-1792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME25014
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License Number State | FL
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