Provider Demographics
NPI:1609647635
Name:CORREA ALFONSO, CAMILO MIGUEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAMILO
Middle Name:MIGUEL
Last Name:CORREA ALFONSO
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:2506 LANSING CIR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9145
Mailing Address - Country:US
Mailing Address - Phone:786-609-2254
Mailing Address - Fax:
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1002
Practice Address - Country:US
Practice Address - Phone:305-243-4210
Practice Address - Fax:305-243-4363
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy