Provider Demographics
NPI:1932939337
Name:CORTEZ, DAVID MISAEL (MA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MISAEL
Last Name:CORTEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 367224
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7224
Mailing Address - Country:US
Mailing Address - Phone:787-428-8442
Mailing Address - Fax:
Practice Address - Street 1:951 CALLE EIDER
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-2335
Practice Address - Country:US
Practice Address - Phone:787-769-5730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6633103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling