Individual
RUBEN CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7815 WALKERS CAY AVE, ORLANDO, FL 32822-7155
(216) 534-4571
Mailing address
7815 WALKERS CAY AVE, ORLANDO, FL 32822-7155
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C631720433290
DRIVERS LICENSE
FL
Enumeration date
03/05/2018
Last updated
06/16/2018
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