Provider Demographics
NPI:1083669717
Name:CORONA, CYNTHIA ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ROSE
Last Name:CORONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 CROWN POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-8369
Mailing Address - Country:US
Mailing Address - Phone:850-453-1472
Mailing Address - Fax:
Practice Address - Street 1:6000 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0001
Practice Address - Country:US
Practice Address - Phone:850-505-6836
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233237208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice