Individual
MRS. MYRNA I CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.P.T.
Contact information
Practice address
CARR #2 KM 40.5, PLAZA JARDINEZ, VEGA BAJA, PR 00693
(787) 858-4845
(787) 858-4845
Mailing address
PO BOX 4375, VEGA BAJA, PR 00694-4375
(787) 858-4845
(787) 858-4845
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
655
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0084190
MEDICARE PROVIDER NUMBER
PR
Enumeration date
10/20/2005
Last updated
05/27/2008
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