Organization Active NPI

Corcoba Family Health Care

  • Primary Care Clinic/Center
  • Champions Gate, FL
National Provider Identifier
1639046345
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CORCOBA FAMILY HEALTH CARE
Practice address
8390 Champions Gate Blvd Ste 108
Champions Gate, FL 33896-8311
Phone
(863) 521-4497
Fax
(815) 205-4677
NPI assigned
Oct 20, 2025
Last updated
Oct 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Elizabeth Leon Corcoba, NURSE PACTITIONERNPI 1740948355
Title
Owner
Phone
(816) 682-7985

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

8390 Champions Gate Blvd Ste 108
Champions Gate, FL 33896-8311

Mailing address

8390 Champions Gate Blvd Ste 108
Champions Gate, FL 33896-8311
Phone (863) 521-4497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260112001906 FL Part B Supplier - Clinic/Group Practice 6709362593 Receives reassigned benefits from 1 practitioner
Practice locations: Champions Gate, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2335477Corcoba Family Health Care LLC8390 Champions Gate Blvd, Unit 108, Champions Gate, FL 33896Certificate of waiverDec 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1639046345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD STE 108",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968311",
            "telephone_number": "863-521-4497",
            "fax_number": "815-205-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD STE 108",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968311",
            "telephone_number": "863-521-4497",
            "fax_number": "815-205-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORCOBA FAMILY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-19",
        "status": "A",
        "authorized_official_last_name": "LEON CORCOBA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-682-7985",
        "authorized_official_credential": "NURSE PACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champions Gate, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.