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1366507006 NPI number — IVAN JOSE CORTES MD

NPI Number: 1366507006
Health Care Provider/Practitioner: IVAN JOSE CORTES MD

Information about “1366507006” NPI (IVAN JOSE CORTES MD) exists in 1366507006 in HTML format HTML  |  1366507006 in plain Text format TXT  |  1366507006 in PDF (Portable Document Format) PDF  |  1366507006 in an XML format XML  formats.

NPI Number : 1366507006 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366507006",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CORTES",
    "FirstName": "IVAN",
    "MiddleName": "JOSE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CORTES",
    "OtherFirstName": "IVAN",
    "OtherMiddleName": "JOSE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "38 CALLE CAPRI",
    "SecondLineMailingAddress": "PASEO LAS BRISAS",
    "MailingAddressCityName": "SAN JUAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00926-5947",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-748-0046",
    "MailingAddressFaxNumber": "787-287-2273",
    "FirstLinePracticeLocationAddress": "44 CALLE CARAZO",
    "SecondLinePracticeLocationAddress": "OFFICE 2B",
    "PracticeLocationAddressCityName": "GUAYNABO",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00969-5603",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-287-6545",
    "PracticeLocationAddressFaxNumber": "787-287-2273",
    "EnumerationDate": "12/22/2006",
    "LastUpdateDate": "10/14/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "9935",
          "LicenseNumberStateCode": "PR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207V00000X",
          "TaxonomyName": "Obstetrics & Gynecology Physician",
          "LicenseNumber": "9935",
          "LicenseNumberStateCode": "PR",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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