Individual
CORALYS GALLOZA BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
920 SW 67TH AVE, MIAMI, FL 33144-4761
(787) 207-4529
Mailing address
920 SW 67TH AVE, MIAMI, FL 33144-4761
(787) 207-4529
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5590
FL
Other
Enumeration date
09/07/2018
Last updated
02/11/2020
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