Provider Demographics
NPI:1871473280
Name:CORDERO, DAUNID RAFAEL
Entity type:Individual
Prefix:
First Name:DAUNID
Middle Name:RAFAEL
Last Name:CORDERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25208 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6339
Mailing Address - Country:US
Mailing Address - Phone:786-315-6143
Mailing Address - Fax:
Practice Address - Street 1:6900 DANIELS PKWY STE 36
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1587
Practice Address - Country:US
Practice Address - Phone:239-936-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT43742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist