Provider Demographics
NPI:1164496790
Name:CORRALES HIGUERA, YURI (MD)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:CORRALES HIGUERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YURI
Other - Middle Name:E
Other - Last Name:CORRALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:516 BLVD MEDIA LUNA APT 1603
Mailing Address - Street 2:ALTOS DEL ESCORIAL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-5065
Mailing Address - Country:US
Mailing Address - Phone:787-768-4278
Mailing Address - Fax:787-769-2220
Practice Address - Street 1:820 AVE ITURREGUI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-1723
Practice Address - Country:US
Practice Address - Phone:787-768-4278
Practice Address - Fax:787-769-2220
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15271207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRP968OtherFIRST MEDICAL
PR100479OtherCRUZ AZUL
PR9240090OtherHUMANA HMO & PPO
PR22650COOtherSSS
PRSE4746OtherPALIC
PRP968OtherFIRST MEDICAL
PR118836Medicare UPIN