Provider Demographics
NPI:1952900839
Name:CORDOVI CANCIO, YIPSIA MAYRELIS (TCM)
Entity type:Individual
Prefix:MRS
First Name:YIPSIA
Middle Name:MAYRELIS
Last Name:CORDOVI CANCIO
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 SW 79TH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6755
Mailing Address - Country:US
Mailing Address - Phone:786-587-4821
Mailing Address - Fax:305-614-8255
Practice Address - Street 1:3837 SW 79TH AVE APT A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6755
Practice Address - Country:US
Practice Address - Phone:786-587-4821
Practice Address - Fax:305-614-8255
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator