MEDICARE: LYANETT CORONA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	18404	FL

General Provider Information

NPI Number	:	1144752775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYANETT CORONA

Provider Business Mailing Address
First Line	:	700 SW 64TH PKWY
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33023-1532
Country	:	US
Telephone Number	:	786-287-1940
Fax Number	:

Provider Business Practice Location Address
First Line	:	7800 SW 57TH AVE STE 205
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5542
Country	:	US
Telephone Number	:	305-854-2471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2017
Last Update Date	:	02/21/2025

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Directions to “ LYANETT CORONA ” Practice Location

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