Healthcare Provider Details
I. General information
NPI: 1073179321
Provider Name (Legal Business Name): CORA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2019
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8449 SW HIGHWAY 200 STE 141
OCALA FL
34481-9695
US
IV. Provider business mailing address
PO BOX 150
LIMA OH
45802-0150
US
V. Phone/Fax
- Phone: 352-693-3378
- Fax: 888-758-9645
- Phone: 419-221-6717
- Fax: 419-222-0507
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
KRZYMINSKI
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 419-221-6717