MEDICARE: MARIA MILAGROS CORTES-VARGAS

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	2133	PR

General Provider Information

NPI Number	:	1811283286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MILAGROS CORTES-VARGAS

Provider Business Mailing Address
First Line	:	1008 AVE AMERICO MIRANDA
Second Line	:	REPARTO METROPOITANO
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2842
Country	:	US
Telephone Number	:	787-751-5315
Fax Number	:	787-772-9261

Provider Business Practice Location Address
First Line	:	1008 AVE AMERICO MIRANDA
Second Line	:	REPARTO METROPOITANO
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2842
Country	:	US
Telephone Number	:	787-751-5315
Fax Number	:	787-772-9261

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

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	06/23/2011

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