Individual provider Active NPI

Coral Del Mar Vazquez Minondo, AU.D

  • Audiologist
  • Hampton, VA
National Provider Identifier
1578892428
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
600 Issued in PR
Practice address
100 Emancipation Dr
Hampton, VA 23667-0001
Phone
(757) 722-9961
NPI assigned
Dec 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X TX
Audiologist 231H00000X AY 1715 FL
Audiologist-Hearing Aid Fitter 237600000X TX
Audiologist 231H00000X 600 PR Primary

Addresses

Primary practice location

100 Emancipation Dr
Hampton, VA 23667-0001

Mailing address

100 Emancipation Dr
Hampton, VA 23667-0001
Phone (757) 722-9961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY 1715FLMDAudiologist
600PRMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1578892428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961",
            "fax_number": "787-709-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ MINONDO",
        "first_name": "CORAL",
        "middle_name": "DEL MAR",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY 1715",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PR",
            "license": "600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.