Healthcare Provider Details

I. General information

NPI: 1073432332
Provider Name (Legal Business Name): CORYNNE ERATO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORYNNE OLIVEIRA

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4924 SW HAMMOCK CREEK DR
PALM CITY FL
34990-7902
US

IV. Provider business mailing address

4924 SW HAMMOCK CREEK DR
PALM CITY FL
34990-7902
US

V. Phone/Fax

Practice location:
  • Phone: 772-285-7366
  • Fax:
Mailing address:
  • Phone: 772-285-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11049015
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: