MEDICARE: TIANA CORONADO

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
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1780382341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA CORONADO

Provider Business Mailing Address
First Line	:	300 E MADISON ST STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-4813
Country	:	US
Telephone Number	:	646-363-7152
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E MADISON ST STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-4813
Country	:	US
Telephone Number	:	646-363-7152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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Directions to “ TIANA CORONADO ” Practice Location

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