| Medical Coral Way Center Corp | |
|
1401 S Military Trl Suite C-1 West Palm Beach FL 33415-5720 | |
| (561) 429-3122 | |
| (561) 429-3124 |
| Full Name | Medical Coral Way Center Corp |
|---|---|
| Speciality | General Practice |
| Location | 1401 S Military Trl, West Palm Beach, Florida |
| Authorized Official Name and Position | Mariela Cruz (PRESIDENT) |
| Authorized Official Contact | 5614293122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Coral Way Center Corp 1401 S Military Trl Suite C West Palm Beach FL 33415-5720 Ph: (561) 429-3122 | Medical Coral Way Center Corp 1401 S Military Trl Suite C-1 West Palm Beach FL 33415-5720 Ph: (561) 429-3122 |
| NPI Number | 1396780185 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 10/01/2009 |
| Medicare PECOS PAC ID | 5496738536 |
|---|---|
| Medicare Enrollment ID | O20040610000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396780185 | NPI | - | NPPES |
| HCC4058 | Other | FL | HEALTH CARE CLINIC LICENS |
| Provider Name | Luis F Gutierrez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003911975 PECOS PAC ID: 3375626468 Enrollment ID: I20080213000126 |
| Provider Name | Jose F Allongo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568496685 PECOS PAC ID: 9739400953 Enrollment ID: I20150609002992 |
| Provider Name | Maria Salazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730538984 PECOS PAC ID: 6608157599 Enrollment ID: I20170109001883 |
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