Provider Demographics
NPI:1831272046
Name:CORZO, HECTOR R (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:R
Last Name:CORZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7955 66TH ST
Mailing Address - Street 2:STE.D
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2161
Mailing Address - Country:US
Mailing Address - Phone:727-541-3362
Mailing Address - Fax:727-544-4015
Practice Address - Street 1:7955 66TH ST
Practice Address - Street 2:STE.D
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2161
Practice Address - Country:US
Practice Address - Phone:727-541-3362
Practice Address - Fax:727-544-4015
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00357732084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62240OtherBLUE CROSS BLUE SHIELD
FL039609500Medicaid
FL62240OtherBLUE CROSS BLUE SHIELD