Provider Demographics
NPI:1255918942
Name:CORAL WAY HEALTH CENTER CORP
Entity type:Organization
Organization Name:CORAL WAY HEALTH CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-392-1274
Mailing Address - Street 1:9159 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2302
Mailing Address - Country:US
Mailing Address - Phone:305-392-1274
Mailing Address - Fax:786-953-5752
Practice Address - Street 1:12855 SW 132ND ST STE 207A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7207
Practice Address - Country:US
Practice Address - Phone:305-608-5572
Practice Address - Fax:786-250-5094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-27
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC12527OtherAHCA