| Kent R Corral Md Pl | |
|
2409 W Azeele St Tampa FL 33609 | |
| (813) 253-3009 | |
| (813) 253-0593 |
| Full Name | Kent R Corral Md Pl |
|---|---|
| Speciality | Internal Medicine |
| Location | 2409 W Azeele St, Tampa, Florida |
| Authorized Official Name and Position | Kent R Corral (OWNER) |
| Authorized Official Contact | 8132533009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kent R Corral Md Pl 2409 W Azeele St Tampa FL 33609 Ph: (813) 253-3009 | Kent R Corral Md Pl 2409 W Azeele St Tampa FL 33609 Ph: (813) 253-3009 |
| NPI Number | 1295825271 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6800859638 |
|---|---|
| Medicare Enrollment ID | O20041111000620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295825271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kent R Corral |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841263209 PECOS PAC ID: 7810968955 Enrollment ID: I20041109000641 |
| Provider Name | Robert M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265691331 PECOS PAC ID: 0840368783 Enrollment ID: I20081006000511 |
| Provider Name | Mabel Z Echeandia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063565471 PECOS PAC ID: 0244424026 Enrollment ID: I20101105000417 |
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