Doctor Name: | DR. ANGEL MANUEL CORTES |
NPI Number: | 1083654222 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14344 |
Business Practice Address: | 5563 10th St Jackson Correctional Institution Malone, FL - 324453129 |
Business Phone Number: | 8505695260 |
Business Fax Number: | |
Mailing Address: | 5643 Sioux Dr, TALLAHASSEE |
State: | FL |
Postal Code: | 323179402 |
Phone Number: | 8507658610 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2006 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14344 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |