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General NPI Number Information
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NPI Number | 1366507006
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Entity Type | Individual
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Provider Name | IVAN JOSE CORTES MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 44 CALLE CARAZO OFFICE 2B
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City | GUAYNABO
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State | PR
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Zip | 00969-5603
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Country | US
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Telephone | 787-287-6545
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Fax | 787-287-2273
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Provider Business Mailing Address
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Address Line | 38 CALLE CAPRI PASEO LAS BRISAS
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City | SAN JUAN
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State | PR
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Zip | 00926-5947
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Country | US
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Telephone | 787-748-0046
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Fax | 787-287-2273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9935
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 9935
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License Number State | PR
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