Provider Demographics
NPI:1053587436
Name:CORREA, DANEEL (MD)
Entity type:Individual
Prefix:DR
First Name:DANEEL
Middle Name:
Last Name:CORREA
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 1:17025 84TH CT N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1705
Mailing Address - Country:US
Mailing Address - Phone:786-489-2999
Mailing Address - Fax:
Practice Address - Street 1:3840 COCONUT CREEK PKWY
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1617
Practice Address - Country:US
Practice Address - Phone:954-580-8867
Practice Address - Fax:954-659-9694
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine