Provider Demographics
NPI:1770629768
Name:CORTEZ, RENEE (DNP, MSN, BSN, ACNP)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:DNP, MSN, BSN, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 FALLING STAR LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7493
Mailing Address - Country:US
Mailing Address - Phone:914-473-8655
Mailing Address - Fax:
Practice Address - Street 1:1241 E DYER RD STE 145
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5694
Practice Address - Country:US
Practice Address - Phone:949-449-1112
Practice Address - Fax:714-368-0843
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301855363LA2100X
FLARNP9302490363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1770629768OtherNPI
NY03843607Medicaid