Provider Demographics
NPI:1265156368
Name:CORUGEDO, ADA MARIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:ADA
Middle Name:MARIA
Last Name:CORUGEDO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:ADA
Other - Middle Name:M
Other - Last Name:CORUGEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:10660 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3613
Mailing Address - Country:US
Mailing Address - Phone:305-213-9708
Mailing Address - Fax:
Practice Address - Street 1:10660 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3613
Practice Address - Country:US
Practice Address - Phone:305-213-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional