ANTONIO JOSE CORDOVA (NPI# 1245795996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245795996 |
| Entity Type | Individual |
| Full Name | ANTONIO JOSE CORDOVA |
| Credential | APRN |
| Practice Address |
12900 Cortez Blvd Ste 102 Brooksville FL 34613-6897 |
| Mailing Address |
1202 Mariner Blvd Spring Hill FL 34609-5603 |
| Practice Telephone | 3525967660 |
| Practice Fax Number | 3525965581 |
| Mailing Telephone | 3522775305 |
| Mailing Fax Number | 3526160926 |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-10-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN11000965 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
11000965 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 11000965 | 05 | |
| FL | FL MEDICAL LICENSE | APRN11000965 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104151455 | Antonio Cordova | Pharmacist | 3670 Parker Blvd, Suite 200, Pueblo, CO 81008-2207 | 2009-10-05 |
| 1649257767 | Antonio Cordova IIi | Specialist/Technologist | 4001 26th St, Vero Beach, FL 32960-1930 | 2005-12-29 |
| Street Address |
12900 CORTEZ BLVD STE 102 |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34613-6897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417963778 | Mauricio Bermudez | Family Medicine | 12900 Cortez Blvd Ste 102, Brooksville, FL 34613-6897 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196836 | Izza Bazigh | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, Sr 50, Office of Graduate Medic, Brooksville, FL 34613 | 2020-05-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1407405822 | Medical Risk Solutions | Family Medicine | 12080 Cortez Blvd, Brooksville, FL 34613 | 2019-09-09 |
| 1528529245 | Edward Joseph Waseleski Jr. | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-26 |
| 1366903213 | Paresh Rangani | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-25 |
| 1225558034 | Whitney King | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, State Road 50, Brooksville, FL 34613 | 2017-06-22 |
| 1922450022 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 13217 Cortez Rd, Brooksville, FL 34613 | 2016-07-13 |
| 1992157408 | Arushi Goel | Internal Medicine | 11375 Cortez Boulevard, Oak Hill Hospital, Brooksville, FL 34613 | 2016-07-08 |
| 1366823122 | Monicka Stella Felix | Internal Medicine | 11375 Cortez Boulevard, Sr 50, Oak Hill Hospital, Gme Attn: Melissa Tammaro, Brooksville, FL 34613 | 2015-06-17 |
| 1790171700 | April Greer | Hearing Instrument Specialist | 13013 Cortez Blvd., Brooksville, FL 34613 | 2015-04-07 |
| Find all providers in zip 34613 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740477454 | Susan Mary Minter | Nurse Practitioner | 21344 Race Horse Ln, Brooksville, FL 34604-6735 | 2007-09-26 |
| 1104247360 | Kimberly D Mccabe | Nurse Practitioner | 7276 Broad St, Brooksville, FL 34601-5591 | 2013-12-13 |
| 1194006072 | Laura Lynn Koach | Nurse Practitioner | 12083 Cortez Blvd, Brooksville, FL 34613-7350 | 2011-09-06 |
| 1942429550 | Stephen Plummer | Nurse Practitioner | 12148 Cortez Blvd, Brooksville, FL 34613 | 2007-04-24 |
| 1255359535 | Robin Eugenia Mariani | Nurse Practitioner | 14540 Cortez Blvd, Suite 108, Brooksville, FL 34613-6056 | 2006-07-17 |
| 1093759524 | Lorelle J Smith | Nurse Practitioner | 11479 Cortez Blvd, Brooksville, FL 34613-7367 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193292 | Paulette Vital-herne | Nurse Practitioner | 4449 Old Highway 41 S, Sun City, FL 33586-9700 | 2020-10-26 |
| 1144828104 | Shilpa Narahari Reddy | Nurse Practitioner | 19435 N Coquina Way, Weston, FL 33332-2417 | 2020-10-13 |
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1154928612 | Haili Harless | Nurse Practitioner | 3961 23rd Ave N, Saint Petersburg, FL 33713-4850 | 2020-10-07 |
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1851998082 | Sanon Edmond | Nurse Practitioner | 5236 Arbor Glen Cir, Lake Worth, FL 33463-8066 | 2020-10-01 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1780291526 | Ilmary De Los Angeles Jimenez | Nurse Practitioner | 7909 Biltmore Blvd, Miramar, FL 33023-5829 | 2020-09-25 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1760097745 | Amanee Orra | Nurse Practitioner | 3982 Bee Ridge Rd Ste H-a, Sarasota, FL 34233-1211 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | BROOKSVILLE |
| Zip Code | 34613 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.