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NPI Code Detail

MEDICARE: STEPHANOR CORIOLAN

MEDICARE:   STEPHANOR  CORIOLAN
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
1246ZC0007XSurgical Assistant

General Provider Information

NPI Number : 1750917464
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANOR CORIOLAN
Provider Business Mailing Address
First Line : 729 SHERWOOD TERRACE DR APT 105
Second Line :
City : ORLANDO
State : FL
Zip : 32818-7404
Country : US
Telephone Number : 561-618-6881
Fax Number :
Provider Business Practice Location Address
First Line : 729 SHERWOOD TERRACE DR APT 105
Second Line :
City : ORLANDO
State : FL
Zip : 32818-7404
Country : US
Telephone Number : 561-618-6881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2020
Last Update Date : 03/14/2020

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Directions to “ STEPHANOR CORIOLAN ” Practice Location

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