Healthcare Provider Details

I. General information

NPI: 1245370642
Provider Name (Legal Business Name): MAUREEN F CORTESE RN CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 RAYMOND ST
ORLANDO FL
32803-8208
US

IV. Provider business mailing address

5201 RAYMOND ST
ORLANDO FL
32803-8208
US

V. Phone/Fax

Practice location:
  • Phone: 321-397-6036
  • Fax: 407-599-1571
Mailing address:
  • Phone: 321-397-6036
  • Fax: 407-599-1571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN845342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: