Provider Demographics
| NPI: | 1982117446 |
|---|---|
| Name: | CORA HEALTH SERVICES INC |
| Entity type: | Organization |
| Organization Name: | CORA HEALTH SERVICES INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE VICE PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | STEPHEN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | KRZYMINSKI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 419-221-6717 |
| Mailing Address - Street 1: | PO BOX 150 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LIMA |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 45802-0150 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 419-221-6717 |
| Mailing Address - Fax: | 419-222-0507 |
| Practice Address - Street 1: | 9560 CROSSHILL BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | JACKSONVILLE |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 32222-5850 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 904-573-0046 |
| Practice Address - Fax: | 904-573-0772 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2017-11-07 |
| Last Update Date: | 2023-09-28 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| FL | 261QR0400X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |