MEDICARE: YSABEL SOFIA DEL CARMEN CORREA GUZMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1043150923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YSABEL SOFIA DEL CARMEN CORREA GUZMAN

Provider Business Mailing Address
First Line	:	8167 NW 41ST ST APT 101
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33166-6274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9900 LAKE FOREST BLVD STE F
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2609
Country	:	US
Telephone Number	:	504-620-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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