Provider Demographics
NPI:1104868439
Name:CORA, VILMA (MD)
Entity Type:Individual
Prefix:DR
First Name:VILMA
Middle Name:
Last Name:CORA
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:PANORAMA ESTATES
Mailing Address - Street 2:CALLE 2 #A9
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-508-1002
Mailing Address - Fax:
Practice Address - Street 1:1791 CALLE ESTEBAN PADILLA
Practice Address - Street 2:SANTIAGO IGLESIAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921-4237
Practice Address - Country:US
Practice Address - Phone:787-783-0399
Practice Address - Fax:787-793-3965
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10770207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10770OtherSTATE MEDICAL LICENSE
PR0083630Medicare ID - Type Unspecified