| Coral Diagnostic Center Inc | |
|
12002 Sw 128th Ct Ste 202 Miami FL 33186-4643 | |
| (786) 362-6114 | |
| Not Available |
| Full Name | Coral Diagnostic Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12002 Sw 128th Ct Ste 202, Miami, Florida |
| Authorized Official Name and Position | Yania Lugo-perez (NURSE PRACTITIONER) |
| Authorized Official Contact | 3058733203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coral Diagnostic Center Inc 12002 Sw 128th Ct Ste 202 Miami FL 33186-4643 Ph: (786) 362-6114 | Coral Diagnostic Center Inc 12002 Sw 128th Ct Ste 202 Miami FL 33186-4643 Ph: (786) 362-6114 |
| NPI Number | 1932718509 |
|---|---|
| Provider Enumeration Date | 07/29/2020 |
| Last Update Date | 07/29/2020 |
| Medicare PECOS PAC ID | 6709204100 |
|---|---|
| Medicare Enrollment ID | O20200917000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932718509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Yania Lugo Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235748054 PECOS PAC ID: 1951729367 Enrollment ID: I20200918001113 |
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