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NPI Code Detail

MEDICARE: INGRID TATIANA FIALLO CORONADO M.D.

MEDICARE:   INGRID TATIANA FIALLO CORONADO  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME111064FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HA855YOTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184992919
Entity Type Code : Individual
Provider Name (Legal Business Name) : INGRID TATIANA FIALLO CORONADO M.D.
Provider Business Mailing Address
First Line : 9679 LAKE NONA VILLAGE PL STE 103
Second Line :
City : ORLANDO
State : FL
Zip : 32827-7310
Country : US
Telephone Number : 407-826-1895
Fax Number : 321-203-4601
Provider Business Practice Location Address
First Line : 9679 LAKE NONA VILLAGE PL STE 103
Second Line :
City : ORLANDO
State : FL
Zip : 32827-7310
Country : US
Telephone Number : 407-826-1895
Fax Number : 321-203-4601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2011
Last Update Date : 09/24/2024

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Directions to “ INGRID TATIANA FIALLO CORONADO M.D.” Practice Location

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