Provider Demographics
NPI:1811320096
Name:CORIOLAN, VALERIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:CORIOLAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 SW TROUVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3716
Mailing Address - Country:US
Mailing Address - Phone:772-240-6830
Mailing Address - Fax:
Practice Address - Street 1:807 SW TROUVILLE AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3716
Practice Address - Country:US
Practice Address - Phone:772-240-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5207235164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse