Organization
AMRON VITALITY AND WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA M CORDERO MD (OWNER)
(904) 802-7048
Entity
Organization
Contact information
Practice address
6339 ARGYLE FOREST BLVD STE 3, JACKSONVILLE, FL 32244-6601
(904) 802-7048
(904) 802-7068
Mailing address
6339 ARGYLE FOREST BLVD STE 3, JACKSONVILLE, FL 32244-6601
(904) 802-7048
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10185B
BCBS PROVIDER
FL
Enumeration date
09/17/2019
Last updated
09/17/2019
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