Active NPI
Edwin Cordero, DC
- Chiropractor
- Lantana, FL
National Provider Identifier
1891784583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH006930
- Practice address
- 3208 Lantana Rd
Lantana, FL 33462-2432 - Phone
- (561) 533-3884
- Fax
- (561) 439-7348
- NPI assigned
- Oct 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH006930 | FL | Primary |
Addresses
Primary practice location
3208 Lantana Rd
Lantana, FL 33462-2432
Mailing address
3208 Lantana Rd
Lantana, FL 33462-2432
Phone (561) 533-3884
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 380743600 | Medicaid | FL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH006930 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1891784583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3208 LANTANA RD",
"city": "LANTANA",
"state": "FL",
"postal_code": "334622432",
"telephone_number": "561-533-3884",
"fax_number": "561-439-7348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3208 LANTANA RD",
"city": "LANTANA",
"state": "FL",
"postal_code": "334622432",
"telephone_number": "561-533-3884",
"fax_number": "561-439-7348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDERO",
"first_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH006930",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "380743600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lantana, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.