Provider Demographics
NPI:1275735938
Name:CORREA, YADIRA MAYTTEE (MD)
Entity Type:Individual
Prefix:
First Name:YADIRA
Middle Name:MAYTTEE
Last Name:CORREA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CALLE 25 NE
Mailing Address - Street 2:
Mailing Address - City:PUERTO NUEVO
Mailing Address - State:PR
Mailing Address - Zip Code:00920-2531
Mailing Address - Country:US
Mailing Address - Phone:787-299-7100
Mailing Address - Fax:
Practice Address - Street 1:309 CALLE 25 NE
Practice Address - Street 2:
Practice Address - City:PUERTO NUEVO
Practice Address - State:PR
Practice Address - Zip Code:00920-2531
Practice Address - Country:US
Practice Address - Phone:787-299-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16956207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine