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NPI Code Detail

MEDICARE: MR. REY CORDOVA HARO PT

MEDICARE: MR. REY CORDOVA HARO PT
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
1225100000XPhysical TherapistPT25213FL

General Provider Information

NPI Number : 1922340272
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. REY CORDOVA HARO PT
Provider Business Mailing Address
First Line : 207 KINGSLEY BLVD
Second Line :
City : AUBURNDALE
State : FL
Zip : 33823-5705
Country : US
Telephone Number : 706-333-2982
Fax Number :
Provider Business Practice Location Address
First Line : 1919 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-2901
Country : US
Telephone Number : 863-688-5612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 03/25/2013

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