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General NPI Number Information
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NPI Number | 1821444241
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Entity Type | Organization
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Legal Business Name | CORA HEALTH
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 16103 STAGS LEAP DR
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City | LUTZ
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State | FL
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Zip | 33559-2003
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Country | US
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Telephone | 813-325-9562
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Fax |
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Provider Business Mailing Address
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Address Line | 16103 STAGS LEAP DRIVE
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 813-325-9562
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | YELLITZA ESTRADA
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Credential | PTA
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Telephone | 813-751-5723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PTA 26602
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License Number State | FL
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