Provider Demographics
NPI:1851622302
Name:CORREALIMA, REBECA
Entity Type:Individual
Prefix:MS
First Name:REBECA
Middle Name:
Last Name:CORREALIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 SW 137TH AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1411
Mailing Address - Country:US
Mailing Address - Phone:305-382-9991
Mailing Address - Fax:305-382-9550
Practice Address - Street 1:9000 SW 137TH AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1411
Practice Address - Country:US
Practice Address - Phone:305-382-9991
Practice Address - Fax:305-382-9550
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381812251X0800X
FLPT251262251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFO227YMedicare PIN