Provider Demographics
NPI:1376106823
Name:CORACI, VERONICA (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:
Last Name:CORACI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4379
Mailing Address - Country:US
Mailing Address - Phone:850-216-0100
Mailing Address - Fax:850-216-0138
Practice Address - Street 1:2100 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4379
Practice Address - Country:US
Practice Address - Phone:850-216-0100
Practice Address - Fax:850-216-0138
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9114070363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical