Corazon de Jesus Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CORAZON DE JESUS MEDICAL CENTER LLC

Practice address

4908 SW 8TH St
Coral Gables, FL 33134-2439

Phone

(305) 964-7749

Fax

(786) 534-2917

NPI assigned

Dec 7, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carlos Alberto Diaz Valladares, APRN

Title

Owner

Phone

(786) 488-4301

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1174390454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 SW 8TH ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342439",
            "telephone_number": "305-964-7749",
            "fax_number": "786-534-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 SW 8TH ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342439",
            "telephone_number": "305-964-7749",
            "fax_number": "786-534-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAZON DE JESUS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-07",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "DIAZ VALLADARES",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-488-4301",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Liat Corcia, M.D.
• David Cordero, CRNA
• Sandra Cordero, RBT
• Amanda Michelle Cordo
• Carolina Cordovez

• Family Medicine Physician in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.