Provider Demographics
NPI:1477928216
Name:CORONADO, NATALI (ATC LAT)
Entity Type:Individual
Prefix:
First Name:NATALI
Middle Name:
Last Name:CORONADO
Suffix:
Gender:F
Credentials:ATC LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 S LOOP 499 APT L1
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-2521
Mailing Address - Country:US
Mailing Address - Phone:956-466-9778
Mailing Address - Fax:
Practice Address - Street 1:1200 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-3921
Practice Address - Country:US
Practice Address - Phone:956-825-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT41892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer