Provider Demographics
NPI:1144310962
Name:CORAL WAY HEALTH CENTER INC.
Entity type:Organization
Organization Name:CORAL WAY HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-878-4756
Mailing Address - Street 1:8890 SW 24TH ST
Mailing Address - Street 2:STE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2060
Mailing Address - Country:US
Mailing Address - Phone:305-225-0947
Mailing Address - Fax:305-225-0949
Practice Address - Street 1:8890 SW 24TH ST
Practice Address - Street 2:STE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2060
Practice Address - Country:US
Practice Address - Phone:305-225-0947
Practice Address - Fax:305-225-0949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty