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General NPI Number Information
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NPI Number | 1548365463
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Entity Type | Individual
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Provider Name | MICHAEL ANDREW CORBIN M.D., L.L.C.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 915 MIDDLE RIVER DR #510
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3544
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Country | US
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Telephone | 954-565-4322
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Fax |
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Provider Business Mailing Address
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Address Line | 915 MIDDLE RIVER DR #510
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3544
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Country | US
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Telephone | 954-565-4322
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME88058
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 047072
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34907
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License Number State | TN
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