Individual
JACQUELINE CORREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D. M. D.
Contact information
Practice address
12538 SW 120TH ST, MIAMI, FL 33186-9064
(305) 646-6700
Mailing address
12538 SW 120TH ST, MIAMI, FL 33186-9064
(305) 646-6700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 17602
FL
Other
Enumeration date
06/20/2007
Last updated
04/03/2017
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