Healthcare Provider Details

I. General information

NPI: 1649084971
Provider Name (Legal Business Name): JOEL CORREA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 METROPOLIS WAY STE 101
ORLANDO FL
32811-2706
US

IV. Provider business mailing address

1028 ABELL CIR
OVIEDO FL
32765-7010
US

V. Phone/Fax

Practice location:
  • Phone: 321-344-1273
  • Fax:
Mailing address:
  • Phone: 954-709-9433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: