Healthcare Provider Details

I. General information

NPI: 1720293608
Provider Name (Legal Business Name): TANIA ELIE CORTAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2007
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11209 N TATUM BLVD STE 200
PHOENIX AZ
85028-3093
US

IV. Provider business mailing address

9535 E VIA MONTOYA
SCOTTSDALE AZ
85255-5014
US

V. Phone/Fax

Practice location:
  • Phone: 480-530-4200
  • Fax: 833-465-1459
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number43662
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number43662
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: