Provider Demographics
NPI:1689803157
Name:EDMI Y CORTES TORRES MD PA
Entity Type:Organization
Organization Name:EDMI Y CORTES TORRES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDMI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CORTES TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-317-2134
Mailing Address - Street 1:PO BOX 278533
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-8533
Mailing Address - Country:US
Mailing Address - Phone:786-317-2134
Mailing Address - Fax:
Practice Address - Street 1:1695 NW 9TH AVE
Practice Address - Street 2:(D-29) ROOM #3100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1409
Practice Address - Country:US
Practice Address - Phone:786-317-2134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97126261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty