Provider Demographics
NPI:1710749346
Name:CORDEIRO ANDERSON, LUISA MARIA
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:MARIA
Last Name:CORDEIRO ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUISA
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2200 NW CORPORATE BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7307
Mailing Address - Country:US
Mailing Address - Phone:561-866-2939
Mailing Address - Fax:
Practice Address - Street 1:2200 NW CORPORATE BLVD STE 306
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7307
Practice Address - Country:US
Practice Address - Phone:561-866-2939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health