Provider Demographics
NPI:1982190336
Name:CORTES, SONIA MARILY
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:MARILY
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 1:11735 CONSTANCE WAY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7877
Mailing Address - Country:US
Mailing Address - Phone:787-484-7961
Mailing Address - Fax:
Practice Address - Street 1:214 S DILLARD ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3523
Practice Address - Country:US
Practice Address - Phone:407-877-0029
Practice Address - Fax:407-358-5207
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL35892355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant