1538170147 NPI number — DR. CARLA ROSCIO CORDOVA MD ANESTHESIOLOGIST

Table of content: DR. CARLA ROSCIO CORDOVA MD ANESTHESIOLOGIST (NPI 1538170147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538170147 NPI number — DR. CARLA ROSCIO CORDOVA MD ANESTHESIOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORDOVA
Provider First Name:
CARLA
Provider Middle Name:
ROSCIO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD ANESTHESIOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RODRIGUEZ
Provider Other First Name:
CARLA
Provider Other Middle Name:
ROSCIO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538170147
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 016370 (R-370)
Provider Second Line Business Mailing Address:
1611 NW 12TH AVE, C302. UM ANESTHESIOLOGY
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-585-1446
Provider Business Mailing Address Fax Number:
305-545-7094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 NW 12TH AVE, C302
Provider Second Line Business Practice Location Address:
UNIVERSITY OF MIAMI, DEPARTMENT OF ANESTHESIOLOGY
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-585-1446
Provider Business Practice Location Address Fax Number:
305-545-7094
Provider Enumeration Date:
08/10/2006

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: 207L00000X , with the licence number:  016423 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: ME100236 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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