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General NPI Number Information
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NPI Number | 1982847133
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Entity Type | Organization
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Legal Business Name | EUNICE CORDOBA MDPA
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 12959 PALMS WEST DR SUITE 120
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4937
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Country | US
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Telephone | 305-803-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 12959 PALMS WEST DR SUITE 120
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4937
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Country | US
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Telephone | 305-803-9887
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MRS. EUNICE CORDOBA
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Credential | M.D.
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Telephone | 561-687-5837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | ME 92149
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License Number State | FL
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