Boris E Coronado MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

72110 Issued in FL

Legal business name

BORIS E CORONADO MD PA

Practice address

5579 S Orange Ave
Edgewood, FL 32809-3493

Phone

(407) 290-0935

Fax

(407) 290-0935

NPI assigned

Apr 6, 2007

Last updated

Jan 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Boris Efrain Coronado, MDNPI 1285687632

Title

President

Phone

(407) 290-0935

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Boris E Coronado, MD

  • Internal Medicine Physician
  • Maitland, FL
  • NPI 1285687632

  Specialist

  NPD (past) Authorized official

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1487776605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 CHERRY RIDGE DR",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327461943",
            "telephone_number": "407-290-0935",
            "fax_number": "407-290-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5579 S ORANGE AVE",
            "city": "EDGEWOOD",
            "state": "FL",
            "postal_code": "328093493",
            "telephone_number": "407-290-0935",
            "fax_number": "407-290-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORIS E CORONADO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "CORONADO",
        "authorized_official_first_name": "BORIS",
        "authorized_official_middle_name": "EFRAIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-290-0935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "72110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dignity Wellness Partners, LLC
• Jordan Paige Goodman, CRT, RRT
• Sharayah McDermott, RD, LD
• Orlando Physician Specialists LLC
• Orlando Physician Specialists LLC

• Specialist in Edgewood, FL
• Providers in Edgewood, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.