Individual provider Active NPI

Stephanie Marie-Louise Coriolan, MD

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1508489972
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME161243 Issued in FL
Practice address
2004 N Flamingo Rd
Pembroke Pines, FL 33028-3500
Phone
(954) 450-8500
Fax
(954) 450-8502
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME161243 FL Primary

Addresses

Primary practice location

2004 N Flamingo Rd
Pembroke Pines, FL 33028-3500

Mailing address

4780 SW 64TH Ave Ste 103
Davie, FL 33314-4400
Phone (954) 434-1705

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830002944 FL Practitioner - Internal Medicine 5597128025 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Drexel University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associatesmd Medical Group IncGroup PAC ID 6507294311, 38 clinicians

Practice addresses (Care Compare)

2004 N Famingo Rd
Pembroke Pines, FL 33028-3500
Phone (954) 450-8500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME161243FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chen Neighborhood Medical Centers of South Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients
Conviva Medical Center Management LLC Internal Medicine CurrentSince Jan 8, 2024 Accepting new patients

Locations

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

410 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (305) 827-2977

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

20801 NW 2nd Ave
Miami Gardens, FL 33169

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

6037 Kimberly Blvd
North Lauderdale, FL 33068
Phone (954) 379-8994

480 N State Road 7
Plantation, FL 33317
Phone (954) 791-9580

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1508489972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 SW 64TH AVE STE 103",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144400",
            "telephone_number": "954-434-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330283500",
            "telephone_number": "954-450-8500",
            "fax_number": "954-450-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORIOLAN",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE-LOUISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME161243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.