Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME89844 | FL |
N | 2081P2900X | Pain Medicine | ME89844 | FL |
NPI | 1154317238 |
---|---|
Provider Name | Margarita Correa Perez |
First Address | Clermont, FL 34711-3124 |
Second Address | Orlando, FL 32803-1047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 25/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000265800 | (05) | FL |
000265801 | (05) | FL |
D08791 | (02) | PR |