| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CARLOS MARIO CORELLA | 1407439045 | 2021-05-23 |
Carlos Mario Corella is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1407439045. Registration indicates Carlos Mario Corella is a provider of services with a specialization in Technologists, Technicians & Other Technical Service Providers, Technician, Pathology (Technician, Pathology: Phlebotomy, ) (Technician, Pathology Phlebotomy, Technologists, Technicians & Other Technical Service Providers) (Technician, Pathology, )
| Entity Type | Individual |
| Provider Name | Carlos Mario Corella RMA |
| Other Provider Name | Carlos Mario Corella |
| Practice Office Address | 914 DEFOREST AVE IOWA CITY, IA US |
| Practice Office Telephone | 3196213095 |
| Practice Office Fax | 8448836979 |
| Mailing Address | 914 DEFOREST AVE IOWA CITY, IA 522402140 US |
| Business Telephone | 3196213095 |
| Business Fax | 8448836979 |
| Code | Practice | License No State |
|---|---|---|
| 246RP1900X PRIMARY | Technologists, Technicians & Other Technical Service Providers Technician, Pathology Technician, Pathology: Phlebotomy Technician, Pathology Phlebotomy Technologists, Technicians & Other Technical Service Providers Technician, Pathology | 190586
IA |
| 193400000X SING | Group Code |