Individual provider Active NPI

Anelys Correa, D.M.D

  • General Practice Dentistry
  • Pembroke Pines, FL
National Provider Identifier
1902117591
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN19129 Issued in FL
Practice address
500 N Hiatus Rd
Suite 109
Pembroke Pines, FL 33026-5213
Phone
(954) 431-8484
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN19129 FL Primary

Addresses

Primary practice location

500 N Hiatus Rd
Suite 109
Pembroke Pines, FL 33026-5213

Mailing address

300 NW 114TH Ave Apt 106
Miami, FL 33172-4753
Phone (305) 318-8884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171221000021 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799043782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN19129FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Gonzalez D.M.D, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1902117591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NW 114TH AVE APT 106",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331724753",
            "telephone_number": "305-318-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HIATUS RD",
            "address_2": "SUITE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265213",
            "telephone_number": "954-431-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "ANELYS",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.