# MR. JORGE L CORDOVA - RUIZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1477967545
- **Gender:** Man
- **Credential:** M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 019114 | PR | Yes |

## Other

- **Enumeration date:** 06/17/2014
- **Last updated:** 03/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1477967545 | 1477967545 | PR |