Provider Demographics
NPI:1932504800
Name:BYRD-CORDOVA, RONALD EUGENE JR (LMHC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:EUGENE
Last Name:BYRD-CORDOVA
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 N FERN CREEK AVENUE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803
Mailing Address - Country:US
Mailing Address - Phone:818-570-2749
Mailing Address - Fax:407-830-8413
Practice Address - Street 1:543 N FERN CREEK AVENUE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:818-570-2749
Practice Address - Fax:407-830-8413
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2022-12-23
Deactivation Date:2015-02-16
Deactivation Code:
Reactivation Date:2022-12-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health