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NPI Code Detail

MEDICARE: MRS. LUISA YAMISEL CORRALES-IGLESIAS DDS

MEDICARE: MRS. LUISA YAMISEL CORRALES-IGLESIAS DDS
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
11223G0001XGeneral Practice DentistryDN 17100FL

General Provider Information

NPI Number : 1861546277
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LUISA YAMISEL CORRALES-IGLESIAS DDS
Provider Business Mailing Address
First Line : 4538 NW 183RD ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33055-3045
Country : US
Telephone Number : 305-625-8272
Fax Number : 305-625-8271
Provider Business Practice Location Address
First Line : 4538 NW 183RD ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33055-3045
Country : US
Telephone Number : 305-625-8272
Fax Number : 305-625-8271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 12/15/2010

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Directions to “ MRS. LUISA YAMISEL CORRALES-IGLESIAS DDS” Practice Location

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