MEDICARE: MR. GREGORIO A. CORTES-MAISONET MD

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	208D00000X	General Practice Physician	16033	PR

General Provider Information

NPI Number	:	1639151616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORIO A. CORTES-MAISONET MD

Provider Business Mailing Address
First Line	:	PO BOX 13867
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00908-3867
Country	:	US
Telephone Number	:	787-726-8396
Fax Number	:	787-919-0640

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	:	787-919-0640

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

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	07/10/2024

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