Individual
CORAL CORDERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2760 DORA AVE, TAVARES, FL 32778-4970
(352) 742-7837
(352) 508-5113
Mailing address
11344 GROVE ST, LEESBURG, FL 34788-4431
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA17490
FL
Other
Enumeration date
12/19/2016
Last updated
08/30/2021
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