| Cordova Medical Group Corp | |
|
7815 Coral Way Ste 103 Miami FL 33155-6541 | |
| (786) 554-2254 | |
| Not Available |
| Full Name | Cordova Medical Group Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 7815 Coral Way Ste 103, Miami, Florida |
| Authorized Official Name and Position | Yaquelin Rodriguez (OWNER) |
| Authorized Official Contact | 7865542254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cordova Medical Group Corp 7815 Coral Way Ste 103 Miami FL 33155-6541 Ph: () - | Cordova Medical Group Corp 7815 Coral Way Ste 103 Miami FL 33155-6541 Ph: (786) 554-2254 |
| NPI Number | 1740963149 |
|---|---|
| Provider Enumeration Date | 08/11/2023 |
| Last Update Date | 08/11/2023 |
| Medicare PECOS PAC ID | 4688020878 |
|---|---|
| Medicare Enrollment ID | O20231024003140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740963149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Guillermo Somodevilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124113782 PECOS PAC ID: 9931288867 Enrollment ID: I20101207000657 |
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