Provider Demographics
NPI:1457248213
Name:CORONEL, SKYE LIANE EDUARTE
Entity type:Individual
Prefix:
First Name:SKYE LIANE
Middle Name:EDUARTE
Last Name:CORONEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SKYE
Other - Middle Name:
Other - Last Name:CORONEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11917 W 109TH ST APT 209
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3981
Mailing Address - Country:US
Mailing Address - Phone:214-259-6208
Mailing Address - Fax:
Practice Address - Street 1:3215 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1946
Practice Address - Country:US
Practice Address - Phone:816-472-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist