ELSY M. CORONADO, MD, PA
Managed Care Organizations at Pines Blvd, Hollywood, FL

License number
Florida ME91527
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: DR. ELSY M CORONADO M.D.
Title: OWNER
Phone: (305) 710-9937
Address
Address
9692 Pines Blvd, Hollywood, FL 33024
National Provider ID: 1497060529
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ELSY M CORONADO M.D. PA

Hollywood, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
VOLUNTARY DISSOLUTION
Registration:
Sep 22, 2009
Inactive since:
Feb 11, 2014
Addresses:
18305 NW 21 St, Hollywood, FL 33029 (Physical)
Pembroke Pines, FL 33082 (Mailing)
PO Box 822637, Hollywood, FL 33082
9692 Pne Blvd, Hollywood, FL 33024
State ID:
P09000078687
Business type:
Florida Profit Corporation
President:
Elsy M Coronado President, inactive, 18305 NW 21 St, Hollywood, FL 33029 (Physical)
Agent:
Coronado Elsy,18305 NW 21 St, Hollywood, FL 33029 (Physical)
EIN:
320291214

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