Provider Demographics
NPI:1235500422
Name:CORETTI, NICHOLAS JOSEPH III (DPM)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:CORETTI
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:15773 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1588
Mailing Address - Country:US
Mailing Address - Phone:305-712-6395
Mailing Address - Fax:305-630-8590
Practice Address - Street 1:2951 NW 49TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-1608
Practice Address - Country:US
Practice Address - Phone:954-486-5700
Practice Address - Fax:954-484-2574
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO3838213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery