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General NPI Number Information
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NPI Number | 1619862802
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Entity Type | Individual
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Provider Name | SABRINA RAQUEL CORREA DMD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 3 SW 129TH AVE STE 210
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1779
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Country | US
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Telephone | 954-450-6447
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 REESE RD APT 418
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City | DAVIE
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State | FL
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Zip | 33314-1226
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Country | US
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Telephone | 954-895-5349
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN30400
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License Number State | FL
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