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General NPI Number Information
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NPI Number | 1841483393
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Entity Type | Organization
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Legal Business Name | MARGARITA CORREA LLC
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Dates
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Enumeration Date | 08/18/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 720 ALMOND ST
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City | CLERMONT
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State | FL
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Zip | 34711-3124
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Country | US
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Telephone | 352-404-6959
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Fax | 352-404-6960
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Provider Business Mailing Address
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Address Line | 720 ALMOND ST
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City | CLERMONT
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State | FL
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Zip | 34711-3124
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Country | US
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Telephone | 352-404-6959
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Fax | 352-404-6960
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARGARITA CORREA-PEREZ
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Credential | MD
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Telephone | 352-404-6959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | ME89844
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME89844
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License Number State | FL
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