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General NPI Number Information
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NPI Number | 1295094746
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Entity Type | Organization
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Legal Business Name | DANEEL CORREA MD PA
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 15574 SW 114TH ST
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City | MIAMI
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State | FL
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Zip | 33196-6301
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Country | US
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Telephone | 786-489-2999
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Fax | 786-953-4990
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Provider Business Mailing Address
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Address Line | 15574 SW 114TH ST
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City | MIAMI
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State | FL
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Zip | 33196-6301
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Country | US
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Telephone | 786-489-2999
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Fax | 786-953-4990
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANEEL CORREA
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Credential | MD
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Telephone | 786-489-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME107473
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License Number State | FL
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