NPIMap

Individual provider Active NPI

Boris E Coronado, MD

  • Internal Medicine Physician
  • Maitland, FL
National Provider Identifier
1285687632
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME72110 Issued in FL
Practice address
800 N Maitland Ave Ste 101
Maitland, FL 32751-4499
Phone
(407) 660-7150
Fax
(407) 660-7108
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0072110 FL
Internal Medicine Physician 207R00000X ME72110 FL Primary

Addresses

Primary practice location

800 N Maitland Ave Ste 101
Maitland, FL 32751-4499

Mailing address

800 N Maitland Ave Ste 101
Maitland, FL 32751-4499
Phone (407) 660-7150

Other identifiers 1

IdentifierTypeStateIssuer
256399100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027000227 FL Practitioner - Internal Medicine 8527085893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600

Hospital & facility affiliations

  • Family Home Care Group LLC Home health agency, Orlando, FL, CCN 103144
  • Mederi Caretenders Home health agency, Longwood, FL, CCN 108014
  • Adventhealth Home Health Home health agency, Altamonte Springs, FL, CCN 107211
  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0072110FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc Internal Medicine CurrentSince Apr 22, 2020 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Inc Internal Medicine Past Accepting new patients
Boris E Coronado MD PA Specialist Past Accepting new patients
Orlando Hospitalists LLC Specialist Past Accepting new patients
Orlando Health Medical Group Inc Internal Medicine Past Accepting new patients

Locations

800 N Maitland Ave
Ste 101
Maitland, FL 32751
Phone (407) 660-7150

89 W Copeland Dr
Orlando, FL 32806
Phone (407) 237-6333

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Interoperability endpoints

  • Direct secure messaging: bcoronado10055@orlandohealth.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1285687632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MAITLAND AVE STE 101",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514499",
            "telephone_number": "407-660-7150",
            "fax_number": "407-660-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAITLAND AVE STE 101",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514499",
            "telephone_number": "407-660-7150",
            "fax_number": "407-660-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "BORIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0072110",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME72110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256399100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.