Provider Demographics
NPI:1932456423
Name:CORRALES, JOSSUE (APRN, MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JOSSUE
Middle Name:
Last Name:CORRALES
Suffix:
Gender:M
Credentials:APRN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9725 NW 117TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33178
Mailing Address - Country:US
Mailing Address - Phone:855-975-5119
Mailing Address - Fax:305-413-4276
Practice Address - Street 1:7306 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3804
Practice Address - Country:US
Practice Address - Phone:305-220-0220
Practice Address - Fax:877-370-4783
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9310329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011847100Medicaid