Provider Demographics
NPI:1174195283
Name:CORTES GONZALEZ, ERNESTO JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:JAVIER
Last Name:CORTES GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ERNESTO
Other - Middle Name:J
Other - Last Name:CORTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ERNESTO CORTES, MD
Mailing Address - Street 1:ST. TARRAGONA #161
Mailing Address - Street 2:URB. MARBELLA
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-408-6378
Mailing Address - Fax:
Practice Address - Street 1:550 CALLE CONCEPCION VERA
Practice Address - Street 2:CARR 110 BARRIO PUEBLO
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23042208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice