Provider Demographics
NPI:1801462064
Name:JORGE CORIANO, MARIO JUAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARIO
Middle Name:JUAN
Last Name:JORGE CORIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-0145
Mailing Address - Country:US
Mailing Address - Phone:787-365-3783
Mailing Address - Fax:
Practice Address - Street 1:CENTRO MEDICO DE PUERTO RICO
Practice Address - Street 2:BARRIO MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24303208D00000X, 208D00000X
PR15740-I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program