Provider Demographics
NPI:1366224644
Name:ORLIRIO CORRALES MD LLC
Entity type:Organization
Organization Name:ORLIRIO CORRALES MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLIRIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-753-0025
Mailing Address - Street 1:4761 SW 146TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8900
Mailing Address - Country:US
Mailing Address - Phone:305-753-0025
Mailing Address - Fax:
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-753-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty