Boris E Coronado MD PA

NPI #1487776605 in Edgewood, Florida

Provider Information

NPI Number: 1487776605
Entity Type: Organization
Organization Name: Boris E Coronado MD PA
Primary Specialty: Specialist
Enumeration Date: Apr 6, 2007
Last Updated: Jan 22, 2008

Practice Location

Address: 5579 S ORANGE AVE
City: Edgewood
State: Florida
ZIP Code: 32809-3493
Phone: (407) 290-0935

Authorized Official

Name: DR. BORIS EFRAIN CORONADO, MD
Title: PRESIDENT
Phone: (407) 290-0935

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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