Provider Demographics
NPI:1205027901
Name:CORTES, JAVIER A (HMC)
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:A
Last Name:CORTES
Suffix:
Gender:M
Credentials:HMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 HELICOPTER RD BLDG 3812
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23459-8937
Mailing Address - Country:US
Mailing Address - Phone:757-763-2190
Mailing Address - Fax:
Practice Address - Street 1:1840 COVE RD
Practice Address - Street 2:BLDG 3853
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23459-8910
Practice Address - Country:US
Practice Address - Phone:757-763-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman