Provider Demographics
NPI:1083698351
Name:CORDA, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:CORDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100806
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0806
Mailing Address - Country:US
Mailing Address - Phone:800-901-2102
Mailing Address - Fax:423-892-5838
Practice Address - Street 1:700 W. OAK STREET
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4996
Practice Address - Country:US
Practice Address - Phone:407-846-2266
Practice Address - Fax:407-518-3616
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME82231207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01163OtherBCBS OF FL
FL2273268OtherGHI
FL262183500Medicaid
FLBH471YMedicare PIN
FL262183500Medicaid
FLBH471XMedicare PIN
FL2273268OtherGHI