Active NPI
Coralys Galloza Bonilla, OD
- Optometrist
- Miami, FL
National Provider Identifier
1134602014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC5590
- Practice address
- 920 SW 67TH Ave
Miami, FL 33144-4761 - Phone
- (787) 207-4529
- NPI assigned
- Sep 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC5590 | FL | Primary |
Addresses
Primary practice location
920 SW 67TH Ave
Miami, FL 33144-4761
Mailing address
920 SW 67TH Ave
Miami, FL 33144-4761
Phone (787) 207-4529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190524001952 | FL | Practitioner - Optometry | 7517200017 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC5590 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581379200000",
"number": "1134602014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 SW 67TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331444761",
"telephone_number": "787-207-4529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 SW 67TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331444761",
"telephone_number": "787-207-4529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLOZA BONILLA",
"first_name": "CORALYS",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-07",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC5590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.