Provider Demographics
NPI:1659024271
Name:CORDOVA-FELIPE, SHENETTE R (APRN)
Entity Type:Individual
Prefix:
First Name:SHENETTE
Middle Name:R
Last Name:CORDOVA-FELIPE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2964 SIESTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4134
Mailing Address - Country:US
Mailing Address - Phone:407-334-2394
Mailing Address - Fax:
Practice Address - Street 1:10055 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1902
Practice Address - Country:US
Practice Address - Phone:407-679-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily