MEDICARE: DR. JACQUELINE BEATRIZ CORTIZO-HERNANDEZ 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	208100000X	Physical Medicine & Rehabilitation Physician	ME141352	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972967701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE BEATRIZ CORTIZO-HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 734951
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-4951
Country	:	US
Telephone Number	:	702-899-0595
Fax Number	:	702-977-1496

Provider Business Practice Location Address
First Line	:	777 GLADES RD # BC-71
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-6424
Country	:	US
Telephone Number	:	561-297-4828
Fax Number	:

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

Provider Enumeration Date	:	04/07/2016
Last Update Date	:	12/12/2025

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