MEDICARE: DR. EVELYN CORRALES VARGAS MD

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	207R00000X	Internal Medicine Physician	ME133382	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104244581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVELYN CORRALES VARGAS MD

Provider Business Mailing Address
First Line	:	6200 SW 73RD ST # 69
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4679
Country	:	US
Telephone Number	:	786-662-5465
Fax Number	:	786-533-9246

Provider Business Practice Location Address
First Line	:	6200 SW 73RD ST # 69
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4679
Country	:	US
Telephone Number	:	786-662-5465
Fax Number	:	786-533-9246

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

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	12/15/2025

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