# MARIO AUGUSTO CORONA RUIZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1306247812
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 22921 | PR | Yes |
| 207Y00000X | Otolaryngology Physician | 69904 | MN | — |
| 207YX0901X | Otology & Neurotology Physician | 22921 | PR | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | 4927717 | PR | — |

## Other

- **Enumeration date:** 09/16/2014
- **Last updated:** 10/20/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4937717 | DRIVER LICENSE | PR |