Provider Demographics
NPI:1962827642
Name:CORDOBA TORRES, CARIDAD (FOREIGN MEDICAL DOC)
Entity Type:Individual
Prefix:
First Name:CARIDAD
Middle Name:
Last Name:CORDOBA TORRES
Suffix:
Gender:F
Credentials:FOREIGN MEDICAL DOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17101 NW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3980
Mailing Address - Country:US
Mailing Address - Phone:786-277-3697
Mailing Address - Fax:
Practice Address - Street 1:7171 CORAL WAY STE 315
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1692
Practice Address - Country:US
Practice Address - Phone:786-870-5754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst