Individual
MR. MIGUEL ANGEL CORREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 N 3RD ST, LEESBURG, FL 34748-5105
(787) 594-8079
(352) 360-6582
Mailing address
4521 SW 159TH STREET RD, OCALA, FL 34473-3578
(787) 594-8079
(352) 360-6582
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
13941
PR
2084P0800X
Psychiatry Physician
ACN 603
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013891700
—
FL
01
—
IA462
MEDICARE PTAN
FL
Enumeration date
05/25/2007
Last updated
01/29/2015
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