Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Sandra Nathaly Cordova, MD

Individual provider Internal Medicine Physician · NPI 1407596646

Dr. Sandra Nathaly Cordova, MD is an Internal Medicine in Bronx, New York. Qualified in 2013, 13 years ago. Practices with Lake Wales Physician Services, LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
13
Licensed in
FL
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 920-4417
Fax: (718) 920-8375
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence ME170899 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1407596646
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2022
Last updated in NPPESJuly 10, 2025
Certification dateJuly 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Lake Wales Physician Services, Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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