Provider Demographics
NPI:1538170147
Name:CORDOVA, CARLA ROSCIO (MD ANESTHESIOLOGIST)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:ROSCIO
Last Name:CORDOVA
Suffix:
Gender:F
Credentials:MD ANESTHESIOLOGIST
Other - Prefix:DR
Other - First Name:CARLA
Other - Middle Name:ROSCIO
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 016370 (R-370)
Mailing Address - Street 2:1611 NW 12TH AVE, C302. UM ANESTHESIOLOGY
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101
Mailing Address - Country:US
Mailing Address - Phone:305-585-1446
Mailing Address - Fax:305-545-7094
Practice Address - Street 1:1611 NW 12TH AVE, C302
Practice Address - Street 2:UNIVERSITY OF MIAMI, DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101
Practice Address - Country:US
Practice Address - Phone:305-585-1446
Practice Address - Fax:305-545-7094
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016423207L00000X
FLME100236207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
107529Medicare UPIN
ME0638Medicare ID - Type Unspecified