Provider Demographics
NPI:1245798131
Name:CORTES ORTIZ, CRISTINA (NP)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CORTES ORTIZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 FORT YORK BOULEVARD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M5V1B1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:219 FORT YORK BOULEVARD
Practice Address - Street 2:SUITE 403
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M5V1B1
Practice Address - Country:CA
Practice Address - Phone:647-428-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-09
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily