Provider Demographics
NPI:1174542849
Name:CORZO, YISEL
Entity type:Individual
Prefix:
First Name:YISEL
Middle Name:
Last Name:CORZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 W 51ST PL
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3601
Mailing Address - Country:US
Mailing Address - Phone:305-556-0888
Mailing Address - Fax:
Practice Address - Street 1:551 W 51ST PL
Practice Address - Street 2:SUITE 304
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3601
Practice Address - Country:US
Practice Address - Phone:305-556-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW64171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical