Provider Demographics
NPI:1740450675
Name:CODLING, ALDENE
Entity type:Individual
Prefix:
First Name:ALDENE
Middle Name:
Last Name:CODLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4535
Mailing Address - Country:US
Mailing Address - Phone:772-204-5110
Mailing Address - Fax:855-442-0248
Practice Address - Street 1:1860 SW FOUNTAINVIEW BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4535
Practice Address - Country:US
Practice Address - Phone:772-204-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3122072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily