Provider Demographics
NPI:1548252380
Name:CORONA-AMARO, JUAN M (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:M
Last Name:CORONA-AMARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-0289
Mailing Address - Country:US
Mailing Address - Phone:787-868-0732
Mailing Address - Fax:787-868-0732
Practice Address - Street 1:272 CALLE MARINA
Practice Address - Street 2:EDIFICIO MARINA, OFICINA 2
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-2956
Practice Address - Country:US
Practice Address - Phone:787-868-0732
Practice Address - Fax:787-868-0732
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF47555Medicare UPIN