Provider Demographics
NPI:1750583837
Name:CORDERO, CARLOS ERNESTO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ERNESTO
Last Name:CORDERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:SUITE # 450
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-534-2155
Mailing Address - Fax:305-534-2035
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 450
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-534-2155
Practice Address - Fax:305-534-2035
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME99230207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK843XMedicare UPIN