Provider Demographics
NPI:1912911520
Name:CORDERO, KRISTA BELLE (CNA, HHA)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:BELLE
Last Name:CORDERO
Suffix:
Gender:F
Credentials:CNA, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 PRESTON LN
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-1412
Mailing Address - Country:US
Mailing Address - Phone:321-205-6543
Mailing Address - Fax:
Practice Address - Street 1:202 PRESTON LN
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-1412
Practice Address - Country:US
Practice Address - Phone:321-205-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide