MEDICARE: CORA HEALTH SERVICES, INC

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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1669304796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORA HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	3745 SHAWNEE RD STE 103
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45806-1660
Country	:	US
Telephone Number	:	786-204-1050
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 HOWLAND BLVD STE 114
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-3468
Country	:	US
Telephone Number	:	419-216-9913
Fax Number	:

Authorized Official
Title or Position	:	PAYER RELATIONS
Name	:	STEPHANIE GUTIERREZ
Credential	:
Telephone Number	:	419-216-9913

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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