Provider Demographics
NPI:1184645699
Name:CORDERO TORRES, WILFREDO JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILFREDO
Middle Name:JAVIER
Last Name:CORDERO TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CALLE GUAYABO
Mailing Address - Street 2:URB FINCA ELENA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-642-2604
Mailing Address - Fax:
Practice Address - Street 1:100 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:HOSPITAL HIMA SAN PABLO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16506207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine