1164547238 NPI number — MRS. CINDY NANETTE CORDERO RPH

Table of content: MRS. CINDY NANETTE CORDERO RPH (NPI 1164547238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164547238 NPI number — MRS. CINDY NANETTE CORDERO RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORDERO
Provider First Name:
CINDY
Provider Middle Name:
NANETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164547238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
165 VIA DEL ROCIO
Provider Second Line Business Mailing Address:
VALLE SAN LUIS
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725-3355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-746-5427
Provider Business Mailing Address Fax Number:
787-653-2840

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ANGORA INDUSTRIAL PARK
Provider Second Line Business Practice Location Address:
LOTE 4 BAIROA
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-286-6032
Provider Business Practice Location Address Fax Number:
787-286-6042
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  4207 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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