Provider Demographics
NPI:1144958943
Name:CORREA, CLARISSA MARIA
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:MARIA
Last Name:CORREA
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 1:1917 CALLE RESEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6620
Mailing Address - Country:US
Mailing Address - Phone:787-647-5906
Mailing Address - Fax:
Practice Address - Street 1:ESCUELA DE MEDICINA SAN JUAN BAUTISTA
Practice Address - Street 2:CARR.172 TURABO GARDENS 00727
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-743-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program