Provider Demographics
NPI:1689894925
Name:CORTES, DELMA L
Entity Type:Individual
Prefix:
First Name:DELMA
Middle Name:L
Last Name:CORTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690-0053
Mailing Address - Country:US
Mailing Address - Phone:787-890-1170
Mailing Address - Fax:787-890-1170
Practice Address - Street 1:CARR.110 , KM 8.8 , BO. AGUACATE
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00604
Practice Address - Country:US
Practice Address - Phone:787-890-1170
Practice Address - Fax:787-890-1170
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRLIC . 1880246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31350Medicare ID - Type UnspecifiedPROVIDER IDENTIFIER