| Marlene Tages Cordova, Do, Pa | |
|
600 N Hiatus Rd Ste 201 Pembroke Pines FL 33026-5207 | |
| (549) 526-6378 | |
| Not Available |
| Full Name | Marlene Tages Cordova, Do, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 600 N Hiatus Rd Ste 201, Pembroke Pines, Florida |
| Authorized Official Name and Position | Marlene Cordova (PRESIDENT) |
| Authorized Official Contact | 9543927157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marlene Tages Cordova, Do, Pa Po Box 260626 Pembroke Pines FL 33026-7626 Ph: () - | Marlene Tages Cordova, Do, Pa 600 N Hiatus Rd Ste 201 Pembroke Pines FL 33026-5207 Ph: (549) 526-6378 |
| NPI Number | 1972021400 |
|---|---|
| Provider Enumeration Date | 09/05/2017 |
| Last Update Date | 07/08/2019 |
| Medicare PECOS PAC ID | 3375614407 |
|---|---|
| Medicare Enrollment ID | O20190805003012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972021400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Marlene Tages Cordova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407856685 PECOS PAC ID: 2163314956 Enrollment ID: I20040326000598 |
| Provider Name | Elena C Sucre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427566124 PECOS PAC ID: 3870907082 Enrollment ID: I20210129001613 |
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