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General NPI Number Information
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NPI Number | 1083669717
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Entity Type | Individual
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Provider Name | CYNTHIA ROSE CORONA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6000 W HIGHWAY 98
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City | PENSACOLA
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State | FL
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Zip | 32512-0001
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Country | US
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Telephone | 850-505-6836
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 CROWN POINTE BLVD
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City | PENSACOLA
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State | FL
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Zip | 32506-8369
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Country | US
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Telephone | 850-453-1472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101233237
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License Number State | VA
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