Healthcare Provider Details

I. General information

NPI: 1851392591
Provider Name (Legal Business Name): ANDRES ENRIQUE CORTES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 SW 37TH AVE
MIAMI FL
33145-3051
US

IV. Provider business mailing address

PO BOX 347586
MIAMI FL
33234-7586
US

V. Phone/Fax

Practice location:
  • Phone: 305-442-0066
  • Fax: 305-445-6896
Mailing address:
  • Phone: 305-442-0066
  • Fax: 305-445-6896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME84729
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: