Organization Active NPI

Carlos a Corrales MD LLC

  • Family Medicine Physician
  • Coral Springs, FL
National Provider Identifier
1598806549
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME81768 Issued in FL
Legal business name
CARLOS A CORRALES MD LLC
Practice address
10167 NW 31St St
Ste # 102
Coral Springs, FL 33065-6152
Phone
(954) 255-9760
Fax
(954) 255-9759
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mr. Carlos Corrales, M.D.NPI 1558323485
Title
Doctor
Phone
(954) 255-9760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME81768 FL Primary

Addresses

Primary practice location

10167 NW 31St St
Ste # 102
Coral Springs, FL 33065-6152

Mailing address

10167 NW 31St St
Ste # 102
Coral Springs, FL 33065-6152
Phone (954) 255-9760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080424000364 FL Part B Supplier - Clinic/Group Practice 1254419765 Receives reassigned benefits from 1 practitioner
Practice locations: Margate, FL

National Provider Directory

National Provider Directory

Locations

10167 NW 31st St
Ste 102
Coral Springs, FL 33065
Phone (561) 417-9581

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1598806549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10167 NW 31ST ST",
            "address_2": "STE # 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330656152",
            "telephone_number": "954-255-9760",
            "fax_number": "954-255-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10167 NW 31ST ST",
            "address_2": "STE # 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330656152",
            "telephone_number": "954-255-9760",
            "fax_number": "954-255-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS A CORRALES MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "CORRALES",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "954-255-9760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME81768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.