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NPI Code Detail

MEDICARE: MIKAELA CORSI

MEDICARE: MIKAELA CORSI
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
1363AS0400XSurgical Physician Assistant
2363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1518898758
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAELA CORSI
Provider Business Mailing Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 954-262-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ MIKAELA CORSI ” Practice Location

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