Raul Gustavo Corredor, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME120035 Issued in FL

Practice address

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Phone

(239) 343-2602

Fax

(239) 343-9193

NPI assigned

Jun 2, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

PsychiatryAlso: Neuropsychiatry

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: rcorredor333210@direct.leememorial.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457
  Medicare reassignment Care Compare group NPD
• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• University Healthcare Physicians, Inc.

  • Family Medicine Physician
  • Martinsburg, WV
  • NPI 1659625739

  Psychiatry

  Medicare reassignment NPD
• Brainsintegrative Health LLC

  • Adult Mental Health Clinic/Center
  • Miami, FL
  • NPI 1770114696
  NPD Authorized official
• Lee Health System Inc

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• University Healthcare Physicians Inc

  • Anesthesiology Physician
  • Martinsburg, WV
  • NPI 1417371329
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1548580558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-2062",
            "fax_number": "239-343-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 S HEALTHPARK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083618",
            "telephone_number": "239-343-2602",
            "fax_number": "239-343-9193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 SW 108th Ave",
            "address_2": "ACC Suite 100",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331742555",
            "country_code": "US",
            "telephone_number": "305-348-3627",
            "fax_number": "305-348-4621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3661 S Miami Ave Ste 504",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331334200",
            "country_code": "US",
            "telephone_number": "305-988-0687",
            "fax_number": "844-476-3183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREDOR",
        "first_name": "RAUL",
        "middle_name": "GUSTAVO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME120035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016369200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Correa
• Eduardo Monteiro Correa, D.D.S.
• Corrective Spinal Care of Florida, P.a.
• Jeannette Corredor, PH.D.
• Megan Corredor, APRN
• Christina Correia
• George F Corrent, MD, PHD
• Gary J. Correnti, M.D.
• Nancy Corso, PHYSICAL THERAPY ASS
• Cortes Medical Supply Inc

• Psychiatry Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.