Provider Demographics
NPI:1730268996
Name:HOWARD, COREY LEE (MD)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:LEE
Last Name:HOWARD
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 1:1000 GOODLETTE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5474
Mailing Address - Country:US
Mailing Address - Phone:239-331-2285
Mailing Address - Fax:239-331-2347
Practice Address - Street 1:1000 GOODLETTE RD STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5474
Practice Address - Country:US
Practice Address - Phone:239-331-2285
Practice Address - Fax:239-331-2347
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G27999Medicare UPIN
28189AMedicare ID - Type Unspecified