Candida A Coore, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

OS17253 Issued in FL

Practice address

2080 Child St
Jacksonville, FL 32214-5005

Phone

(045) 427-6009

NPI assigned

Jun 20, 2009

Last updated

Aug 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1275760902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44530 APPLE BLOSSOM DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "045-427-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COORE",
        "first_name": "CANDIDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101018327",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS17253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherdina M Cooper
• Tamorrowi D. Cooper
• Tory Ann Cooper
• Randi Beth Cooperman, PA-C
• Coordinated Wound Care, Inc.
• Diane Copeland, D.C.
• Quanita Michelle Copeland
• Richard Copeland, BACHELOR LEVEL
• Robin Houston Copeland, ARNP
• Courtney Copenhaver, RBT

• Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.