Healthcare Provider Details

I. General information

NPI: 1548154412
Provider Name (Legal Business Name): CORA HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11661 STATE ROAD 70 E
LAKEWOOD RANCH FL
34202-9416
US

IV. Provider business mailing address

PO BOX 150
LIMA OH
45802-0150
US

V. Phone/Fax

Practice location:
  • Phone: 941-222-0321
  • Fax: 941-957-2600
Mailing address:
  • Phone: 786-204-1050
  • Fax: 567-301-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE GUTIERREZ
Title or Position: PAYER RELATIONS
Credential:
Phone: 786-204-1050