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General NPI Number Information
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NPI Number | 1790206605
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Entity Type | Individual
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Provider Name | ANA CAROLINA CORONADO REYNA MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 300 TAYLOR RD STE 700
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City | MONTGOMERY
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State | AL
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Zip | 36117-3551
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Country | US
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Telephone | 334-747-6000
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Fax | 334-747-6025
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Provider Business Mailing Address
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Address Line | 301 BROWN SPRINGS RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-7005
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Country | US
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Telephone |
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 41071
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License Number State | AL
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