Organization
GOCORONA LLC
Active
Other names
Union Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GONZALO CORONA M.D (DIRECTOR)
(575) 578-4815
Entity
Organization
Contact information
Practice address
304 S LEA AVE, ROSWELL, NM 88203-4562
(575) 578-4815
(575) 578-4814
Mailing address
304 S LEA AVE, ROSWELL, NM 88203-4562
(575) 578-4815
(575) 578-4814
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
MD2007-0650
NM
261QP2300X
Primary Care Clinic/Center
Primary
MD2007-0650
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11773537
—
NM
Enumeration date
07/10/2012
Last updated
11/20/2018
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