Provider Demographics
NPI:1174622096
Name:SANCHEZ CORDOVA, ROBERTO (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:SANCHEZ CORDOVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366987
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:787-783-6650
Mailing Address - Fax:787-783-6650
Practice Address - Street 1:1229 JESUS T PINEIRO
Practice Address - Street 2:
Practice Address - City:PUERTO NUEVO
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-783-6650
Practice Address - Fax:787-783-6650
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0049213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10049OtherCIGNA
228011OtherPREFERRED HEALTH PLAN
9360098OtherHUMANA HEALTH INSURANCE
601149OtherMEDICARE MUCHO MAS MMM
50192OtherPREFERRED MEDICAL CHOICE
48063OtherTRIPLE S
9360098OtherHUMANA HEALTH INSURANCE
601149OtherMEDICARE MUCHO MAS MMM