Healthcare Provider Details

I. General information

NPI: 1982022307
Provider Name (Legal Business Name): GINA CORSALETTI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21097 NE 27TH CT STE 320
AVENTURA FL
33180-1206
US

IV. Provider business mailing address

21097 NE 27TH CT STE 320
AVENTURA FL
33180-1206
US

V. Phone/Fax

Practice location:
  • Phone: 305-974-5533
  • Fax:
Mailing address:
  • Phone: 305-974-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME165615
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME165615
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: