Provider Demographics
NPI:1558765446
Name:CORTES DERMATOLOGY & INTERNAL MEDICINE PC
Entity Type:Organization
Organization Name:CORTES DERMATOLOGY & INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GIL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-658-6306
Mailing Address - Street 1:PO BOX 250477
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0477
Mailing Address - Country:US
Mailing Address - Phone:787-658-6306
Mailing Address - Fax:787-658-6308
Practice Address - Street 1:AVE SEVERIANO CUEVAS
Practice Address - Street 2:WESTERN MEDICAL PLAZA, SUITE 19
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-0477
Practice Address - Country:US
Practice Address - Phone:787-658-6306
Practice Address - Fax:787-658-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18888207N00000X
PR18907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRIB189AMedicare PIN