Individual
BENJAMIN CORDOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 SANDY CREEK DR, BRANDON, FL 33511-7918
(813) 458-1241
Mailing address
619 SANDY CREEK DR, BRANDON, FL 33511-7918
(813) 458-1241
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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