Provider Demographics
NPI:1811283286
Name:CORTES-VARGAS, MARIA MILAGROS
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MILAGROS
Last Name:CORTES-VARGAS
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 1:1008 AVE AMERICO MIRANDA
Mailing Address - Street 2:REPARTO METROPOITANO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2842
Mailing Address - Country:US
Mailing Address - Phone:787-751-5315
Mailing Address - Fax:787-772-9261
Practice Address - Street 1:1008 AVE AMERICO MIRANDA
Practice Address - Street 2:REPARTO METROPOITANO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2842
Practice Address - Country:US
Practice Address - Phone:787-751-5315
Practice Address - Fax:787-772-9261
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21331835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist