Enerolisa Altagracia Cordero-Polanco, M.D

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

16133 Issued in PR

Practice address

Ave. Roberto Clemente Bloq 132 # 11
Villa Carolina
Carolina, PR 00985

Phone

(178) 727-6428

NPI assigned

May 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437366531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "007351205",
            "telephone_number": "178-727-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. ROBERTO CLEMENTE BLOQ 132 # 11",
            "address_2": "VILLA CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "178-727-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO-POLANCO",
        "first_name": "ENEROLISA",
        "middle_name": "ALTAGRACIA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "PR",
            "license": "16133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cooperativa de Servicios de Salud de PR
• Giannina Coppola-Fasick, MD
• Angelo Coppola, M.D.
• Jaylin L Corchado Jimenez
• Gabriella Maria Cordero Gallardo, DMD
• Lourdes Del Pilar Cordero, OPTOMETRIST OD
• Maria Del Carmen Cordero, RPH
• Marianis Cordero, PSY. D.
• Migdalia Cordero
• Core Care LLC

• Public Health & General Preventive Medicine Physician in Carolina, PR
• Providers in Carolina, PR by specialty
• Public Health & General Preventive Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.