Healthcare Provider Details

I. General information

NPI: 1972503019
Provider Name (Legal Business Name): LUIS F CORREA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15100 NW 67TH AVE STE 104
MIAMI LAKES FL
33014-2103
US

IV. Provider business mailing address

3801 BISCAYNE BLVD SUITE 300
MIAMI FL
33137-9800
US

V. Phone/Fax

Practice location:
  • Phone: 305-571-0671
  • Fax: 305-362-9823
Mailing address:
  • Phone: 305-571-0620
  • Fax: 305-576-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME51407
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME51407
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: