Provider Demographics
NPI:1205897352
Name:CORTES, LUZ NILSA (MD)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:NILSA
Last Name:CORTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUZ
Other - Middle Name:NILSA
Other - Last Name:CORTES MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4186
Mailing Address - Street 2:
Mailing Address - City:PUERTO REAL
Mailing Address - State:PR
Mailing Address - Zip Code:00740-4186
Mailing Address - Country:US
Mailing Address - Phone:787-801-0000
Mailing Address - Fax:787-860-7105
Practice Address - Street 1:410 AVE GENERAL VALERO
Practice Address - Street 2:TORRE MEDICA HIMA, SUITE 303
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3949
Practice Address - Country:US
Practice Address - Phone:787-801-0000
Practice Address - Fax:787-860-7105
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12895207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH67637Medicare UPIN