MEDICARE: MAXIMINO CORTES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.0008678-SUPV	OH

General Provider Information

NPI Number	:	1598013617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXIMINO CORTES

Provider Business Mailing Address
First Line	:	202 E BAGLEY RD
Second Line	:
City	:	BEREA
State	:	OH
Zip	:	44017-2058
Country	:	US
Telephone Number	:	800-234-2006
Fax Number	:

Provider Business Practice Location Address
First Line	:	16600 W SPRAGUE RD STE 245
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-6319
Country	:	US
Telephone Number	:	440-523-0370
Fax Number	:	877-524-5670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2012
Last Update Date	:	10/22/2025

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Directions to “ MAXIMINO CORTES ” Practice Location

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