Provider Demographics
NPI:1073853735
Name:MORTON S CORIN MD PA
Entity Type:Organization
Organization Name:MORTON S CORIN MD PA
Other - Org Name:DRS CORIN AND GOLDBERG MD PA
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-5220
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-821-5220
Mailing Address - Fax:305-821-9825
Practice Address - Street 1:7100 W 20TH AVE STE 512
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1824
Practice Address - Country:US
Practice Address - Phone:305-821-5220
Practice Address - Fax:305-821-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00168682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91451Medicare PIN