=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578004180
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORTES PHARMACY GROUP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2017
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR 109 KM 2 5 PLAZA SALCEDO
-----------------------------------------------------
City | ANASCO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-826-4145
-----------------------------------------------------
Fax | 787-826-3030
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 59 CALLE DAGUEY
-----------------------------------------------------
City | ANASCO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00610-2602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-826-4145
-----------------------------------------------------
Fax | 787-826-3030
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES
-----------------------------------------------------
Name | GLORIVEE CORTES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-229-1313
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------