Provider Demographics
NPI:1265602692
Name:CORTES, JULIO NARCISO (PA)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:NARCISO
Last Name:CORTES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 NW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2434
Mailing Address - Country:US
Mailing Address - Phone:305-220-6109
Mailing Address - Fax:
Practice Address - Street 1:85 GRAND CANAL DR
Practice Address - Street 2:SUITE 301
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2561
Practice Address - Country:US
Practice Address - Phone:305-262-2629
Practice Address - Fax:305-262-2829
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100012363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant