Provider Demographics
NPI:1215188727
Name:CORENTIN, MARK AARON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:AARON
Last Name:CORENTIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MERIDIAN AVE APT 323
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-7094
Mailing Address - Country:US
Mailing Address - Phone:305-531-7525
Mailing Address - Fax:
Practice Address - Street 1:1313 NW 36TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5581
Practice Address - Country:US
Practice Address - Phone:305-636-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37280183500000X
CTPCT.0009784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist