Provider Demographics
NPI:1114747888
Name:CORRALES, MARTHAYSABEL DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:MARTHAYSABEL
Middle Name:DE LA CARIDAD
Last Name:CORRALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8061 NW 200TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6616
Mailing Address - Country:US
Mailing Address - Phone:786-684-8044
Mailing Address - Fax:
Practice Address - Street 1:8061 NW 200TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6616
Practice Address - Country:US
Practice Address - Phone:786-684-8044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician