MEDICARE: DR. EUNICE CORDOBA M.D.

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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	DR.0069701	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689671943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUNICE CORDOBA M.D.

Provider Business Mailing Address
First Line	:	2905 ROSS DR APT M23
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6936
Country	:	US
Telephone Number	:	561-635-6153
Fax Number	:

Provider Business Practice Location Address
First Line	:	2905 ROSS DR APT M23
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6936
Country	:	US
Telephone Number	:	561-635-6153
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	02/04/2026

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