Healthcare Provider Details

I. General information

NPI: 1932273240
Provider Name (Legal Business Name): RAUL A CORTES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 SW 37TH AVE
COCONUT GROVE FL
33133-2728
US

IV. Provider business mailing address

2734 SW 37TH AVE
COCONUT GROVE FL
33133-2728
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-4263
  • Fax: 305-426-3329
Mailing address:
  • Phone: 305-642-4263
  • Fax: 305-426-3329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberFL116291
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA81602
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberME116291
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: