Provider Demographics
NPI:1760411268
Name:CORRADINI, FRANK ALAN (LCSW)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ALAN
Last Name:CORRADINI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1273
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:FL
Mailing Address - Zip Code:33576-1273
Mailing Address - Country:US
Mailing Address - Phone:352-588-1143
Mailing Address - Fax:
Practice Address - Street 1:6536 STADIUM DR
Practice Address - Street 2:SUITE F
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7586
Practice Address - Country:US
Practice Address - Phone:813-783-2135
Practice Address - Fax:813-783-2135
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 46121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1821Medicare ID - Type Unspecified