MEDICARE: HUGO CORRALES M.D. P.A.

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	208D00000X	General Practice Physician		FL

General Provider Information

NPI Number	:	1780990804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUGO CORRALES M.D. P.A.

Provider Business Mailing Address
First Line	:	4752 BAY POINT RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3318
Country	:	US
Telephone Number	:	305-576-3989
Fax Number	:	305-576-3989

Provider Business Practice Location Address
First Line	:	4752 BAY POINT RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3318
Country	:	US
Telephone Number	:	305-576-3989
Fax Number	:	305-576-3989

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HUGO CORRALES
Credential	:	M.D.
Telephone Number	:	305-576-3989

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	08/26/2010

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