Individual provider · Type 1 NPI
Coral Picillo
Surgical Physician Assistant · Angola, IN
NPI number
1376449579
Active
Practice location
3150 Menards Dr
Angola, IN 46703-7356
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
About NPI 1376449579
Coral Picillo's National Provider Identifier is 1376449579, issued on Oct 15, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Angola, IN. The record was last updated on Oct 15, 2026.