Provider Demographics
NPI:1225281355
Name:CORAL THERAPY CORP
Entity Type:Organization
Organization Name:CORAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-559-8845
Mailing Address - Street 1:8900 CORAL WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2075
Mailing Address - Country:US
Mailing Address - Phone:305-559-8845
Mailing Address - Fax:305-559-8846
Practice Address - Street 1:8900 CORAL WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2075
Practice Address - Country:US
Practice Address - Phone:305-559-8845
Practice Address - Fax:305-559-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center