Provider Demographics
NPI:1568215366
Name:CORDOVI, JULIO CESAR (FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:CORDOVI
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 MEMORIAL HWY STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4564
Mailing Address - Country:US
Mailing Address - Phone:813-890-3400
Mailing Address - Fax:
Practice Address - Street 1:6107 MEMORIAL HWY STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4564
Practice Address - Country:US
Practice Address - Phone:813-890-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily