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General NPI Number Information
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NPI Number | 1295347839
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Entity Type | Organization
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Legal Business Name | CAROLINA CORTEZ PA
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 7420 NW 5TH ST STE 104
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City | PLANTATION
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State | FL
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Zip | 33317-1611
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Country | US
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Telephone | 954-859-5528
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Fax |
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Provider Business Mailing Address
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Address Line | 5175 GENOA ST
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City | AVE MARIA
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State | FL
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Zip | 34142-5093
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINA CORTEZ
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Credential |
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Telephone | 305-431-2661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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