Provider Demographics
NPI:1497123111
Name:CORRALES, ARMANDO (CSFA)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:CORRALES
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 W FLORAL CLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3886
Mailing Address - Country:US
Mailing Address - Phone:602-425-6813
Mailing Address - Fax:
Practice Address - Street 1:2240 W FLORAL CLIFF WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3886
Practice Address - Country:US
Practice Address - Phone:602-425-6813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant