Provider Demographics
NPI:1013198118
Name:CORTES, DENNIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:CORTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 821068
Mailing Address - Street 2:
Mailing Address - City:SOUTH FLORIDA
Mailing Address - State:FL
Mailing Address - Zip Code:33082-1068
Mailing Address - Country:US
Mailing Address - Phone:954-558-5620
Mailing Address - Fax:954-367-4673
Practice Address - Street 1:12600 PEMBROKE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2544
Practice Address - Country:US
Practice Address - Phone:954-435-6211
Practice Address - Fax:954-435-6212
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21171100Medicaid
FL28300AMedicare PIN
FL21171100Medicaid