MEDICARE: BARBARA CORDERO RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1265297303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA CORDERO RODRIGUEZ

Provider Business Mailing Address
First Line	:	846 BOCAVISTA CT
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33896-8641
Country	:	US
Telephone Number	:	407-883-7404
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 E 29TH ST N
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-2169
Country	:	US
Telephone Number	:	316-634-8710
Fax Number	:	316-634-8891

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/26/2026

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