Active NPI
Johanne Coriolan, SA-C
- Surgical Assistant
- Miramar, FL
National Provider Identifier
1780145789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 19-137
- Practice address
- 2621 SW 83Rd Ave
Miramar, FL 33025-7412 - Phone
- (786) 203-2642
- NPI assigned
- Mar 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 19-137 | WI | Primary |
Addresses
Primary practice location
2621 SW 83Rd Ave
Miramar, FL 33025-7412
Mailing address
2621 SW 83Rd Ave
Miramar, FL 33025-7412
Phone (786) 203-2642
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19-137 | WI | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553990400000",
"number": "1780145789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2621 SW 83RD AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330257412",
"telephone_number": "786-203-2642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2621 SW 83RD AVE",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330257412",
"telephone_number": "786-203-2642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORIOLAN",
"first_name": "JOHANNE",
"credential": "SA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-31",
"last_updated": "2019-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "WI",
"license": "19-137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.