Healthcare Provider Details

I. General information

NPI: 1689894925
Provider Name (Legal Business Name): DELMA L CORTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR.110 , KM 8.8 , BO. AGUACATE
AGUADILLA PR
00604
US

IV. Provider business mailing address

PO BOX 53
SAN ANTONIO PR
00690-0053
US

V. Phone/Fax

Practice location:
  • Phone: 787-890-1170
  • Fax: 787-890-1170
Mailing address:
  • Phone: 787-890-1170
  • Fax: 787-890-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License NumberLIC . 1880
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: