Provider Demographics
NPI:1851392591
Name:CORTES, ANDRES ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:ENRIQUE
Last Name:CORTES
Suffix:
Gender:M
Credentials:MD
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 347586
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33234-7586
Mailing Address - Country:US
Mailing Address - Phone:305-442-0066
Mailing Address - Fax:305-445-6896
Practice Address - Street 1:2441 SW 37TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3051
Practice Address - Country:US
Practice Address - Phone:305-442-0066
Practice Address - Fax:305-445-6896
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84729207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26399470Medicaid
FLF15738Medicare UPIN
FL26399470Medicaid