Coral Reef Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME57421 Issued in FL

Legal business name

CORAL REEF MEDICAL GROUP LLC

Practice address

30334 Old Dixie Hwy
Homestead, FL 33033-3215

Phone

(786) 243-0149

Fax

(786) 234-2612

NPI assigned

May 7, 2008

Last updated

Mar 12, 2013By 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

Mr. Robert Blanco

Title

Owner

Phone

(786) 243-0149

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Antonio E Blanco, MD

  • Internal Medicine Physician
  • Homestead, FL
  • NPI 1336231562
  Medicare reassignment Care Compare group NPD
• Marino Esteban Corniel, ARNP

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1194121939
  Medicare reassignment Care Compare group NPD
• Miguel De Jesus Perez Martinez

  • Family Nurse Practitioner
  • Palmetto Bay, FL
  • NPI 1003288291
  Medicare reassignment Care Compare group NPD
• Olga Lopez, PAC

  • Medical Physician Assistant
  • Homestead, FL
  • NPI 1679603237
  Medicare reassignment Care Compare group
• Denis Nunez Sanchez, DNP, APRN, ANCC-BC

  • Family Nurse Practitioner
  • Homestead, FL
  • NPI 1235534546
  Medicare reassignment NPD
• Anisia Otero, MD

  • Family Medicine Physician
  • Miami, FL
  • NPI 1811313190
  Medicare reassignment NPD

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1982870143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30334 OLD DIXIE HWY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330333215",
            "telephone_number": "786-243-0149",
            "fax_number": "786-234-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30334 OLD DIXIE HWY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330333215",
            "telephone_number": "786-243-0149",
            "fax_number": "786-234-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL REEF MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "BLANCO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-243-0149",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ARNP619302",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9103866",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME57421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conviva Medical Center Management LLC
• Cor Medical Centers of Homestead
• Cora Health Services Inc (CORA Physical Therapy - Homestead)
• Cora Health Services Inc. (CORA Physical Therapy - South Homestead)
• Rosa Coradin
• Lidia Esther Cordal
• Aymee Cordero Arias
• Lorna C Cordero Arias
• Lievma Cordero del Sol
• Kiriam Cordero Delgado, OT

• Internal Medicine Physician in Homestead, FL
• Providers in Homestead, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.