Healthcare Provider Details

I. General information

NPI: 1376479170
Provider Name (Legal Business Name): CATHERINE CORTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12811 KENWOOD LN STE 202
FORT MYERS FL
33907-5646
US

IV. Provider business mailing address

14590 SW 38TH ST
MIRAMAR FL
33027-3793
US

V. Phone/Fax

Practice location:
  • Phone: 239-537-9646
  • Fax:
Mailing address:
  • Phone: 954-805-1472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: