Israel Antonio Cordero-Valle, MD
Individual provider Active NPI Internal Medicine Physician · Quebradillas, PR
NPI 1316936404 · NPPES record last updated Sep 9, 2010
Key facts
- NPI
- 1316936404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 9317 (PR)
- Practice address
- 63 Calle San Carlos
Quebradillas, PR 00678-1775 - Phone
- (787) 895-4121
- Fax
- (787) 895-8059
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University Central del Caribe Escuela de Medicina, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
63 Calle San Carlos
Quebradillas, PR 00678-1775
Phone (787) 895-4121
PO Box
Suite 974
Quebradillas, PR 00678-0974
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101028000590 | PR | Practitioner - Internal Medicine | 3971797440 | Practice locations: Quebradillas, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9317 | PR | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 9317 | PR | Yes |
Addresses
Primary practice location
63 Calle San Carlos
Quebradillas, PR 00678-1775
Mailing address
PO Box 974
Quebradillas, PR 00678-0974
Phone (787) 895-4121
Other providers in Quebradillas, PR
- Conexion Innata
- Conexion Innata
- Consultorio Medico Dr Migdonio Camacho Camacho PSC
- Cordero Ambulance Service Inc.
- Josue Francisco Cordero Santiago
- Elizabeth Cordero
- Corporacion Servicios Profesionales Dr. Anibal Pagan
- Yalitza Marie Cortes Medina I
- Creciendo Con Amor LLC
- Juan Carlos Cruz Cruz
All providers in Quebradillas, PR · Internal Medicine Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.