Healthcare Provider Details

I. General information

NPI: 1689593949
Provider Name (Legal Business Name): JOSE E CORA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 CALLE AUGUSTA
SAN JUAN PR
00926-3466
US

IV. Provider business mailing address

1717 CALLE AUGUSTA
SAN JUAN PR
00926-3466
US

V. Phone/Fax

Practice location:
  • Phone: 787-398-4043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number88419
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: