Provider Demographics
NPI:1679558423
Name:CORONA, ABELARDO (MD)
Entity Type:Individual
Prefix:
First Name:ABELARDO
Middle Name:
Last Name:CORONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 BAPTIST WAY
Mailing Address - Street 2:2ND FLOOR, INSIDE PCU
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7600
Mailing Address - Country:US
Mailing Address - Phone:305-779-7022
Mailing Address - Fax:305-779-7007
Practice Address - Street 1:975 BAPTIST WAY
Practice Address - Street 2:2ND FLOOR, INSIDE PCU
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:305-779-7022
Practice Address - Fax:305-779-7007
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN283506OtherWELLCARE
FL269484100Medicaid
FL44122OtherBLUE CROSS BLUE SHIELD
FLP00200079OtherRAILROAD MEDICARE
FL44122OtherBLUE CROSS BLUE SHIELD
FL269484100Medicaid
FLU4126ZMedicare PIN