Provider Demographics
NPI:1982808028
Name:GARCIA CORTES, IDALIA (MD)
Entity type:Individual
Prefix:DR
First Name:IDALIA
Middle Name:
Last Name:GARCIA 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:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0218
Mailing Address - Country:US
Mailing Address - Phone:787-638-0880
Mailing Address - Fax:
Practice Address - Street 1:CARR 852 KM 0 HM 8
Practice Address - Street 2:BO. DOS BOCAS
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-761-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRDM10647-6202C00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1811111OtherDRIVER LICENCE
PR2704138OtherELECTORAL CARD