Provider Demographics
NPI:1336317783
Name:YOLANDA L ANOOS CORDON MD PA
Entity Type:Organization
Organization Name:YOLANDA L ANOOS CORDON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-685-7716
Mailing Address - Street 1:501 EICHENFELD DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5994
Mailing Address - Country:US
Mailing Address - Phone:813-685-7716
Mailing Address - Fax:
Practice Address - Street 1:501 EICHENFELD DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5994
Practice Address - Country:US
Practice Address - Phone:813-685-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31468207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30090Medicare PIN