CORDOVA MEDICAL GROUP CORP
NPI 1740963149
Clinic/Center in Miami, FL

Q: What is Cordova Medical Group Corp's NPI number?

The NPI number for Cordova Medical Group Corp is 1740963149. It was assigned to this organization in the NPPES registry on August 11, 2023.

Q: What is Cordova Medical Group Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since August 11, 2023CLIA 10D2297661 · Waiver

12750 NW 17TH ST UNIT 215, MIAMI, FL 33182(786) 554-2254(888) 503-1582 Get Directions Write a Review

NPPES record last updated: April 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 9, 2026, Aug 11, 2023 (2 updates tracked since 2023).

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About Cordova Medical Group Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CORDOVA MEDICAL GROUP CORP (NPI 1740963149) is a healthcare organization registered as a clinic/center in Miami, Florida and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through January 18, 2028 and lists Yaquelin Rodriguez, Owner, as its authorized official.

NPPES Registry Identity

NPI1740963149

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameCORDOVA MEDICAL GROUP CORP

Location Address12750 NW 17TH ST UNIT 215Miami, FL 33182-1422

Mailing Address12750 Nw 17th St Unit 215Miami, FL 33182-1422 · (786) 554-2254

Phone(786) 554-2254

Fax(888) 503-1582

Organization SubpartNo

Authorized OfficialYaquelin RodriguezOwner · (786) 554-2254

Enumeration DateAugust 11, 2023

Last NPPES UpdateApril 9, 20262 updates tracked since enumeration

NPPES CertifiedApril 9, 2026

✔ NPI 1740963149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

12750 NW 17TH ST UNIT 215, Miami, FL 33182

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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cordova Medical Group Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Cordova Medical Group Corp, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Guillermo Somodevilla, MD

Family Practice

NPI 1124113782

12750 NW 17TH ST UNIT 214
Miami, FL 33182

(305) 269-0385

✔ PECOS✔ Accepts MedicareSame address

Carmen Alonso, APRN

Nurse Practitioner

NPI 1093401416

920 SW 82ND AVE
Miami, FL 33144

(305) 262-3999

✔ PECOS5.0 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2297661

Cordova Medical Group Corp · Miami, FL

Active · expires Jan 18, 2028

CLIA Number10D2297661

Laboratory TypePhysician Office

Certificate Effective DateJanuary 19, 2026

Certificate Expiration DateJanuary 18, 2028

Laboratory DirectorYaquelin Rodriguez

Laboratory Phone(786) 554-2254

Laboratory LocationCordova Medical Group Corp12750 NW 17st Ste 215, Miami, FL 33182

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cordova Medical Group Corp's NPI number?

The NPI number for Cordova Medical Group Corp is 1740963149. It was assigned to this organization in the NPPES registry on August 11, 2023.

Where is Cordova Medical Group Corp located?

Cordova Medical Group Corp is located at 12750 NW 17th St Unit 215, Miami, FL 33182. The listed phone number is (786) 554-2254.

What is Cordova Medical Group Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Cordova Medical Group Corp enrolled in Medicare?

Yes. Cordova Medical Group Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Cordova Medical Group Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Cordova Medical Group Corp, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Cordova Medical Group Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2297661) is associated with this NPI, valid through January 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cordova Medical Group Corp was last updated on April 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.