PEDRO ANTONION MUNERA-CORDOBA (NPI# 1528171469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528171469 |
| Entity Type | Individual |
| Full Name | PEDRO ANTONION MUNERA-CORDOBA |
| Credential | M.D. |
| Practice Address |
1340 Broad Ave Ste 410 Gulfport MS 39501 |
| Mailing Address |
11150 Highway 49n Gulfport MS 39503 |
| Practice Telephone | 2288675202 |
| Practice Fax Number | 2288675007 |
| Mailing Telephone | 2288311700 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2014-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
17363 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09550215 | 05 |
| Street Address |
1340 BROAD AVE STE 410 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912904590 | Jesse Pullen Penico | Internal Medicine | 1340 Broad Ave, Suite 300, Gulfport, MS 39501-2404 | 2005-06-28 |
| 1306409040 | Lissa Kelly Baber | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2019-04-18 |
| 1780191577 | Tbd Acquisition II LLC | Social Worker | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2018-01-03 |
| 1629517115 | Delana Mooney | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2017-02-16 |
| 1396299590 | Charles Strange | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2016-08-05 |
| 1942699988 | Beth Ann Gruzinskas | Nurse Practitioner | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2015-01-14 |
| 1720477714 | Lacey Grimes Lichtenstein | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2015-01-14 |
| 1669872974 | Jamie B Varnado | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2014-08-25 |
| 1700121209 | Danielle Ronquille Lipski | Occupational Therapist | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2012-12-10 |
| 1164767778 | Shannon Ann Church | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2012-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821158742 | Craig Kunins | Psychiatry & Neurology | 2840 Seabreeze Dr S, Gulfport, FL 33707-3910 | 2006-12-11 |
| 1639620560 | North Plantation | Psychiatry & Neurology | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-15 |
| 1609883347 | Brad Z. Berger | Psychiatry & Neurology | 11150 Highway 49n, Gulfport, MS 39503 | 2006-08-02 |
| 1740272723 | Bryan Vyverberg | Psychiatry & Neurology | 15190 Community Rd, Suite 260, Gulfport, MS 39503-3485 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649466954 | Nazmul Talukdar | Psychiatry & Neurology | 110 Patton Ave, Hattiesburg, MS 39401-6155 | 2007-09-20 |
| 1932321742 | Otis Anderson IIi | Psychiatry & Neurology | 5185 Getwell Rd, Southaven, MS 38671-9691 | 2007-05-02 |
| 1770609364 | Gerri L Hill Chance | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazelhurst, MS 39083 | 2007-03-22 |
| 1841337656 | Cynthia Lufkin Undesser | Psychiatry & Neurology | 402 Wesley Ave, Jackson, MS 39202-1000 | 2007-01-31 |
| 1932290392 | Millcreek Epsdt | Psychiatry & Neurology | 900 First Ave., N.e., Magee, MS 39111 | 2006-09-28 |
| 1023363173 | Kelechi Nnamdi Emereonye | Psychiatry & Neurology | 4100 Mamie St, Hattiesburg, MS 39402-1735 | 2012-07-16 |
| 1710175260 | Clinical Neuroscience Group, Pllc | Psychiatry & Neurology | 3531 Lakeland Dr, Suite 1058, Flowood, MS 39232-8049 | 2007-10-10 |
| 1992906598 | Maecenas Inc | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazlehurst, MS 39083-0146 | 2007-05-30 |
| 1154477453 | Anthony Wade Jackson Sr. | Psychiatry & Neurology | 152 Highway 7 S, Oxford, MS 38655-5392 | 2007-01-27 |
| 1073684940 | Timothy Summers | Psychiatry & Neurology | 1818 College Drive, Meridian, MS 39307-5429 | 2006-11-13 |
| Find all providers with the same taxonomy | ||||
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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.