Healthcare Provider Details

I. General information

NPI: 1528995891
Provider Name (Legal Business Name): KATHY CORRESSELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NW 17TH ST STE O
MIAMI FL
33136-1135
US

IV. Provider business mailing address

901 NW 17TH ST STE O
MIAMI FL
33136-1135
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-3995
  • Fax: 305-585-3996
Mailing address:
  • Phone: 305-585-3995
  • Fax: 305-585-3996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS45052
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: