Healthcare Provider Details

I. General information

NPI: 1114547379
Provider Name (Legal Business Name): MARIA A CORONADO BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 S KANNER HWY
STUART FL
34997-7462
US

IV. Provider business mailing address

9070 KIMBERLY BLVD STE 19-20
BOCA RATON FL
33434-2855
US

V. Phone/Fax

Practice location:
  • Phone: 772-349-6317
  • Fax:
Mailing address:
  • Phone: 954-988-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-23-14899
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82721
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: