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General NPI Number Information
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NPI Number | 1306306691
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Entity Type | Individual
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Provider Name | ERICA CORREDERA MD
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Gender | Female
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 1475 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1002
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Country | US
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Telephone | 212-746-9663
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Fax | 305-697-9660
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Provider Business Mailing Address
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Address Line | PO BOX 7411189
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City | CHICAGO
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State | IL
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Zip | 60674-9660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | ME166599
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License Number State | FL
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