Provider Demographics
NPI:1992761852
Name:CASALS, CORAL (MD)
Entity type:Individual
Prefix:
First Name:CORAL
Middle Name:
Last Name:CASALS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 CALLE PAVIA
Mailing Address - Street 2:PAVIA MEDICAL PLAZA SUITE 210
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2239
Mailing Address - Country:US
Mailing Address - Phone:787-728-2318
Mailing Address - Fax:787-728-2359
Practice Address - Street 1:611 CALLE PAVIA
Practice Address - Street 2:PAVIA MEDICAL PLAZA SUITE 210
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-2239
Practice Address - Country:US
Practice Address - Phone:787-728-2318
Practice Address - Fax:787-728-2359
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI29400Medicare UPIN
PR22974Medicare ID - Type Unspecified