Healthcare Provider Details

I. General information

NPI: 1578705455
Provider Name (Legal Business Name): JANICE ANGELA SANTOS CORTES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 SW 57TH AVE STE 516
SOUTH MIAMI FL
33143-3649
US

IV. Provider business mailing address

6705 SW 57TH AVE STE 516
SOUTH MIAMI FL
33143-3649
US

V. Phone/Fax

Practice location:
  • Phone: 786-372-8485
  • Fax:
Mailing address:
  • Phone: 786-372-8485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME107090
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: