Provider Demographics
NPI:1487641924
Name:CORDNER, HAROLD JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JOSEPH
Last Name:CORDNER
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 1:12635 N A1A
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-9414
Mailing Address - Country:US
Mailing Address - Phone:772-589-2033
Mailing Address - Fax:772-589-2088
Practice Address - Street 1:13837 US HIGHWAY 1
Practice Address - Street 2:2
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3232
Practice Address - Country:US
Practice Address - Phone:772-388-9998
Practice Address - Fax:772-388-9742
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62542208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME62542OtherMEDICAL LICENSE #
FLBC3311622OtherDEA #
FLBC3311622OtherDEA #
FLME62542OtherMEDICAL LICENSE #