MEDICARE: DR. GREGORIO A. CORTES-SOTO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	8035	PR

General Provider Information

NPI Number	:	1003858994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORIO A. CORTES-SOTO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1644
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00984-1644
Country	:	US
Telephone Number	:	787-726-8396
Fax Number	:	787-727-6672

Provider Business Practice Location Address
First Line	:	1826 AVE FERNANDEZ JUNCOS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00909-3004
Country	:	US
Telephone Number	:	787-726-8396
Fax Number	:	787-727-6672

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	12/27/2017

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