MEDICARE: EDUARDO CORREA DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1619837770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDUARDO CORREA DDS PA

Provider Business Mailing Address
First Line	:	13432 PALM BEACH BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-2129
Country	:	US
Telephone Number	:	352-871-6142
Fax Number	:

Provider Business Practice Location Address
First Line	:	13432 PALM BEACH BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-2129
Country	:	US
Telephone Number	:	239-694-0834
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDUARDO MONTEIRO CORREA
Credential	:	DDS
Telephone Number	:	239-694-0834

Provider Enumeration Date	:	11/12/2025
Last Update Date	:	11/12/2025

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