Provider Demographics
NPI:1629450093
Name:CORTES, CYNTHIA DENISSE (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENISSE
Last Name:CORTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:DENISSE
Other - Last Name:CORTES AGOSTINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:813-759-1290
Mailing Address - Fax:813-759-1291
Practice Address - Street 1:2004 THONOTOSASSA RD STE 101
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-2915
Practice Address - Country:US
Practice Address - Phone:813-759-1290
Practice Address - Fax:813-759-1291
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME135603207R00000X, 207R00000X
PR31,970-R390200000X
PR33046R390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program