Provider Demographics
NPI:1952427130
Name:CORRIPIO, SEGUNDO J (MD)
Entity type:Individual
Prefix:
First Name:SEGUNDO
Middle Name:J
Last Name:CORRIPIO
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 1:4483 N.W. 36H STREET
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-888-7555
Mailing Address - Fax:954-476-1362
Practice Address - Street 1:6990 NW 37TH AVENUE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33147
Practice Address - Country:US
Practice Address - Phone:305-691-5050
Practice Address - Fax:305-691-0006
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME558442083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCL059YMedicare UPIN
FLCL059ZMedicare UPIN
FLBR885BMedicare PIN
FLBR885CMedicare PIN
FLCL059XMedicare UPIN
FLBR885AMedicare PIN