MEDICARE: MS. MARIA ELENA CORDONES

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	343900000X	Non-emergency Medical Transport (VAN)	C635545775460	FL

General Provider Information

NPI Number	:	1720846637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA ELENA CORDONES

Provider Business Mailing Address
First Line	:	5102 ROYAL POINT AVE
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-6776
Country	:	US
Telephone Number	:	407-738-8628
Fax Number	:	407-269-0903

Provider Business Practice Location Address
First Line	:	5102 ROYAL POINT AVE
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-6776
Country	:	US
Telephone Number	:	407-738-8628
Fax Number	:	407-269-0903

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

Provider Enumeration Date	:	03/06/2024
Last Update Date	:	03/06/2024

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