Provider Demographics
NPI:1104080480
Name:COTRINA, DORA PIEDAD
Entity type:Individual
Prefix:
First Name:DORA
Middle Name:PIEDAD
Last Name:COTRINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 W OAKLAND PARK BLVD
Mailing Address - Street 2:101
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1731
Mailing Address - Country:US
Mailing Address - Phone:954-567-5730
Mailing Address - Fax:
Practice Address - Street 1:871 W OAKLAND PARK BLVD
Practice Address - Street 2:101
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1731
Practice Address - Country:US
Practice Address - Phone:954-567-5730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 32740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor