Healthcare Provider Details

I. General information

NPI: 1144310962
Provider Name (Legal Business Name): CORAL WAY HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8890 SW 24TH ST STE 211
MIAMI FL
33165-2060
US

IV. Provider business mailing address

8890 SW 24TH ST STE 211
MIAMI FL
33165-2060
US

V. Phone/Fax

Practice location:
  • Phone: 305-225-0947
  • Fax: 305-225-0949
Mailing address:
  • Phone: 305-225-0947
  • Fax: 305-225-0949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State

VIII. Authorized Official

Name: BARBARA DIAZ
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 305-878-4756