Healthcare Provider Details

I. General information

NPI: 1124951637
Provider Name (Legal Business Name): CORA HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 ROLLING ACRES RD
LADY LAKE FL
32159-5035
US

IV. Provider business mailing address

3745 SHAWNEE RD STE 103
LIMA OH
45806-1660
US

V. Phone/Fax

Practice location:
  • Phone: 352-254-3367
  • Fax: 352-254-3644
Mailing address:
  • Phone: 419-216-9913
  • Fax: 567-301-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE GUTIERREZ
Title or Position: PAYER RELATIONS
Credential:
Phone: 419-216-9913