Provider Demographics
NPI:1275634800
Name:CORREDOR, OSCAR H (OD, FAAO)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:H
Last Name:CORREDOR
Suffix:
Gender:M
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PALAFOX PL
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5629
Mailing Address - Country:US
Mailing Address - Phone:850-434-2060
Mailing Address - Fax:850-429-8215
Practice Address - Street 1:113 PALAFOX PL
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502
Practice Address - Country:US
Practice Address - Phone:850-434-2060
Practice Address - Fax:850-429-8215
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003027013152W00000X
IA002444152W00000X
FLOPC5727152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103846800Medicaid
FLOPC5727OtherSTATE LICENSE