Healthcare Provider Details

I. General information

NPI: 1346249687
Provider Name (Legal Business Name): GLORIVEE CORTES R.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 CALLE DAGUEY
ANASCO PR
00610-2602
US

IV. Provider business mailing address

HC 6 BOX 67554
AGUADILLA PR
00603-9856
US

V. Phone/Fax

Practice location:
  • Phone: 787-229-1313
  • Fax: 787-826-7384
Mailing address:
  • Phone: 787-891-9044
  • Fax: 787-826-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4712
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: