Active NPI
Mariam Cordero
- Counselor
- Orlando, FL
National Provider Identifier
1417839101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- IMT4308
- Practice address
- 1501 W Colonial Dr
Orlando, FL 32804-7120 - Phone
- (321) 430-5866
- NPI assigned
- Jul 23, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | IMT4308 | FL | Primary |
Addresses
Primary practice location
1501 W Colonial Dr
Orlando, FL 32804-7120
Mailing address
5020 Revolutionary Way
Saint Cloud, FL 34769-1864
Phone (954) 348-8179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT4308 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753228800000",
"number": "1417839101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5020 REVOLUTIONARY WAY",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347691864",
"telephone_number": "954-348-8179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 W COLONIAL DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328047120",
"telephone_number": "321-430-5866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDERO",
"first_name": "MARIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-23",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "IMT4308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.