Healthcare Provider Details

I. General information

NPI: 1306090089
Provider Name (Legal Business Name): MIGDALIA CORTINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2008
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33300 N 32ND AVE STE 205
PHOENIX AZ
85085-8825
US

IV. Provider business mailing address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

V. Phone/Fax

Practice location:
  • Phone: 623-300-9100
  • Fax:
Mailing address:
  • Phone: 623-300-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number72359
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number036.123523
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: