Provider Demographics
NPI:1659338895
Name:CORDOVEZ, PEDRO (AP, DOM)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:CORDOVEZ
Suffix:
Gender:M
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 CHIANTI PL
Mailing Address - Street 2:# 1015
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-7735
Mailing Address - Country:US
Mailing Address - Phone:727-667-1028
Mailing Address - Fax:
Practice Address - Street 1:2188 CHIANTI PL
Practice Address - Street 2:# 1015
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-7735
Practice Address - Country:US
Practice Address - Phone:727-667-1028
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2159171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist