Healthcare Provider Details

I. General information

NPI: 1801590492
Provider Name (Legal Business Name): STEPHANIE CORTINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR STE 900E
MIAMI FL
33176-2213
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-5007
  • Fax:
Mailing address:
  • Phone: 786-662-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME179273
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: