Healthcare Provider Details

I. General information

NPI: 1770048928
Provider Name (Legal Business Name): MARIA V. CORTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2019
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GK 33 AVE ROBERTO SANCHEZ VILELLA SUITE A2 AVE CAMPO RICO
CAROLINA PR
00982
US

IV. Provider business mailing address

PO BOX 706
GUAYNABO PR
00970-0706
US

V. Phone/Fax

Practice location:
  • Phone: 787-556-3399
  • Fax:
Mailing address:
  • Phone: 787-529-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4199
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6197
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6197
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: