Provider Demographics
NPI:1497282875
Name:DUARTE, CORI L (LM, CPM)
Entity Type:Individual
Prefix:
First Name:CORI
Middle Name:L
Last Name:DUARTE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MYRTLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5632
Mailing Address - Country:US
Mailing Address - Phone:813-949-1185
Mailing Address - Fax:
Practice Address - Street 1:106 MYRTLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5632
Practice Address - Country:US
Practice Address - Phone:813-949-1185
Practice Address - Fax:813-949-1162
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL350176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife