DMC Wellness

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME57227 Issued in FL

Legal business name

DMC WELLNESS

Practice address

3604 University Blvd S
Suite 203
Jacksonville, FL 32216-4241

Phone

(904) 479-3432

NPI assigned

Jun 19, 2015

Last updated

Dec 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Diana M Cordero, M.D.

Title

Owner

Phone

(904) 479-3432

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1447632062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 UNIVERSITY BLVD S",
            "address_2": "SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164241",
            "telephone_number": "904-345-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 UNIVERSITY BLVD S",
            "address_2": "SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164241",
            "telephone_number": "904-479-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMC WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "CORDERO",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-479-3432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME57227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.