Individual provider Active NPI

Elio A Coradin, HOUSE PHYSICIAN

  • General Practice Physician
  • Virginia Gardens, FL
National Provider Identifier
1831436740
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
HSE15480 Issued in FL
Practice address
6595 NW 36TH St # C128
Virginia Gardens, FL 33166-6979
Phone
(305) 779-2059
NPI assigned
Jan 11, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X HSE15480 FL Primary

Addresses

Primary practice location

6595 NW 36TH St # C128
Virginia Gardens, FL 33166-6979

Mailing address

6595 NW 36TH St # C128
Virginia Gardens, FL 33166-6979
Phone (305) 779-2059

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

LicenseStateTypeSpecialty
HSE15480FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1831436740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 NW 36TH ST # C128",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666979",
            "telephone_number": "305-779-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 NW 36TH ST # C128",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666979",
            "telephone_number": "305-779-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORADIN",
        "first_name": "ELIO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "HOUSE PHYSICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "HSE15480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.