| Coralmedpr LLC | |
|
Rochelaise Cente Oficina 3d Western Industrial Park Mayaguez PR 00680 | |
| (939) 373-6791 | |
| (708) 854-7667 |
| Full Name | Coralmedpr LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | Rochelaise Cente Oficina 3d, Mayaguez, Puerto Rico |
| Authorized Official Name and Position | Coral Kaoma Jimenez Rovira (OWNER) |
| Authorized Official Contact | 9393736791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coralmedpr LLC 8 Villa Gracia Mayaguez PR 00680-7171 Ph: (939) 373-6791 | Coralmedpr LLC Rochelaise Cente Oficina 3d Western Industrial Park Mayaguez PR 00680 Ph: (939) 373-6791 |
| NPI Number | 1053295816 |
|---|---|
| Provider Enumeration Date | 08/04/2025 |
| Last Update Date | 07/09/2026 |
| Certification Date | 07/09/2026 |
| Medicare PECOS PAC ID | 1557850328 |
|---|---|
| Medicare Enrollment ID | O20251030005069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053295816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | () | Primary |
| Provider Name | Coral Kaoma Jimenez Rovira |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326665746 PECOS PAC ID: 8921493487 Enrollment ID: I20220318001794 |
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