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General NPI Number Information
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NPI Number | 1982374468
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Entity Type | Organization
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Legal Business Name | CORNEILLE MEDICAL TRAINING & CONSULTING
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 6100 LAKE ELLENOR DR STE 300
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City | ORLANDO
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State | FL
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Zip | 32809-4638
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Country | US
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Telephone | 407-358-6640
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 LAKE ELLENOR DR STE 300
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City | ORLANDO
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State | FL
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Zip | 32809-4638
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Country | US
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Telephone | 407-358-6640
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KETURAH JAROMYRE CORNEILLE
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Credential | RN
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Telephone | 407-922-3570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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Taxonomy #5
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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