Provider Demographics
NPI:1164607859
Name:CORRALES, DULCE MARIA (OMD)
Entity Type:Individual
Prefix:DR
First Name:DULCE MARIA
Middle Name:
Last Name:CORRALES
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6003
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32627-6003
Mailing Address - Country:US
Mailing Address - Phone:352-208-9129
Mailing Address - Fax:
Practice Address - Street 1:1031 NW 6TH ST STE B1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4277
Practice Address - Country:US
Practice Address - Phone:352-208-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1593171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist