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General NPI Number Information
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NPI Number | 1801167838
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Entity Type | Organization
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Legal Business Name | CORTES FAMILY PHYSICIANS, P.A.
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 5712 21ST AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-5606
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Country | US
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Telephone | 941-795-0105
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Fax |
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Provider Business Mailing Address
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Address Line | 5712 21ST AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-5606
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Country | US
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Telephone | 941-795-0105
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRISTOBAL EDUARDO CORTES
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Credential | DO
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Telephone | 941-795-0105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8190
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License Number State | FL
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