Provider Demographics
NPI:1326050105
Name:VINDAS CORDERO, JOSE P (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:P
Last Name:VINDAS CORDERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13241 BARTRAM PARK BLVD UNIT 1001
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5234
Mailing Address - Country:US
Mailing Address - Phone:904-292-0863
Mailing Address - Fax:904-212-0884
Practice Address - Street 1:13241 BARTRAM PARK BLVD UNIT 1001
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5234
Practice Address - Country:US
Practice Address - Phone:904-292-0863
Practice Address - Fax:904-212-0884
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 96311174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist