MEDICARE: FERNANDO CORTES

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	207P00000X	Emergency Medicine Physician	MD442815	PA
2	207P00000X	Emergency Medicine Physician	45103	AZ
3	208600000X	Surgery Physician	MT191800	PA
4	207P00000X	Emergency Medicine Physician	32263	NE

General Provider Information

NPI Number	:	1992991202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO CORTES

Provider Business Mailing Address
First Line	:	1800 E FLORENCE BLVD
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-5303
Country	:	US
Telephone Number	:	520-381-6358
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 E FLORENCE BLVD
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-5303
Country	:	US
Telephone Number	:	520-381-6358
Fax Number	:

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

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	08/18/2021

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Directions to “ FERNANDO CORTES ” Practice Location

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