Juan Luis Castro Cordoba (NPI# 1003002106, PAC ID# 1557412756) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1003002106 |
| PAC ID by PECOS | 1557412756 |
| Professional Enrollment ID | I20170413000764 |
| Full Name | Juan Luis Castro Cordoba |
| Organization Legal Name | LEGACY BEHAVIORAL HEALTH CENTER INC |
| Address |
2632 Sw Port St Lucie Blvd Port Saint Lucie FL 34953-2845 |
| Phone Number | 7728738811 |
| Gender | M |
| Graduation Year | 2001 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 3072677756 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2632 Sw Port St Lucie Blvd, Port Saint Lucie, FL 34953-2845 | 7728738811 | LEGACY BEHAVIORAL HEALTH CENTER INC |
| 2640 Forest Hill Blvd, West Palm Beach, FL 33406-5931 | 5616168411 | LEGACY BEHAVIORAL HEALTH CENTER INC |
| Organization Legal Name | LEGACY BEHAVIORAL HEALTH CENTER INC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leah D Scott | Clinical Social Worker | Legacy Behavioral Health Center Inc | 304 Nw 5th St, Okeechobee, FL 34972-2565 |
| Mehrunnis Sultana | Psychiatry | Legacy Behavioral Health Center Inc | 2640 Forest Hill Blvd, West Palm Beach, FL 33406-5931 |
| Cleopatra Ortiz | Psychiatry | Legacy Behavioral Health Center Inc | 726 20th St, Vero Beach, FL 32960-5442 |
| Antonio J Larranaga | Psychiatry | Legacy Behavioral Health Center Inc | 15818 Sw Warfield Blvd, Indiantown, FL 34956-3513 |
| Balinder S. Chahal | Psychiatry | Legacy Behavioral Health Center Inc | 755 27th Ave Sw, Suite 9and10, Vero Beach, FL 32968-4200 |
| Subhash R Tiwari | Psychiatry | Legacy Behavioral Health Center Inc | 726 20th St, Vero Beach, FL 32960-5442 |
| Aimee L Tischuk | Psychiatry | Legacy Behavioral Health Center Inc | 2640 Forest Hill Blvd, West Palm Beach, FL 33406-5931 |
| James B Wirth | Psychiatry | Legacy Behavioral Health Center Inc | 2640 Forest Hill Blvd, West Palm Beach, FL 33406-5931 |
| Street Address |
2632 SW PORT ST LUCIE BLVD |
| City | PORT SAINT LUCIE |
| State | FL |
| Zip | 34953-2845 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gino Alberto Jr. | Emergency Medicine | Dockyard Emergency Physicians, LLC | 3205 Sw Darwin Blvd, Er At Darwin Quare, Port Saint Lucie, FL 34953 |
| Lynne Erbe | Optometry | 1721 Swgatlin Blvd, Port Saint Lucie, FL 34953 | |
| Duviel Rodriguez | Clinical Social Worker | 1949 Sw Idaho Ln, Port St Lucie, FL 34953-1883 | |
| Robert Iannacone | Podiatry | 691 Sw Port St Lucie Blvd, Port St. Lucie, FL 34953-1998 | |
| Brett Daniel Schoch | Chiropractic | Simpson Chiropractic Pain and Wellness Center Pa | 464 Sw Port St Lucie Blvd, Suite 114, Port Saint Lucie, FL 34953-2077 |
| Magalys Koch | Clinical Social Worker | 718 Sw Port St Lucie Blvd, Suite E5, Port St Lucie, FL 34953-2670 | |
| Philip C Desantis | Optometry | 1850 Sw Gatlin Blvd, Port St Lucie, FL 34953-2703 | |
| Joseph L Pate | Chiropractic | Absolute Healthcare Advanced Chiropractic P A | 1973 Swsavage Blvd, Suite 111, Port Saint Lucie, FL 34953-2791 |
| Laura M Pate | Chiropractic | Absolute Healthcare Advanced Chiropractic P A | 1973 Swsavage Blvd, Suite 111, Port Saint Lucie, FL 34953-2791 |
| Gitana O Ng | Nurse Practitioner | 3318 Sw Blue Ct, Port St Lucie, FL 34953-3559 | |
| Find all physicians in zip 34953 | |||
| City | PORT SAINT LUCIE |
| Zip Code | 34953 |
| Specialty | PSYCHIATRY |
| City + Specialty | PORT SAINT LUCIE + PSYCHIATRY |
Please comment or provide details below to improve the information on Juan Luis Castro Cordoba.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.