Provider Demographics
NPI:1952567216
Name:CORTIJO-CORTES, ZIOLLY S (MD,)
Entity Type:Individual
Prefix:DR
First Name:ZIOLLY
Middle Name:S
Last Name:CORTIJO-CORTES
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 WESTWOOD BLVD
Mailing Address - Street 2:STE 475
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6027
Mailing Address - Country:US
Mailing Address - Phone:407-845-0330
Mailing Address - Fax:888-972-1752
Practice Address - Street 1:1044 PLAZA DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-4064
Practice Address - Country:US
Practice Address - Phone:407-350-5659
Practice Address - Fax:407-350-5662
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17254208D00000X
FLACN410208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006487000Medicaid