Provider Demographics
NPI:1992565139
Name:CORTEZ INJURY CARE LLC
Entity type:Organization
Organization Name:CORTEZ INJURY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAXIME
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-213-9371
Mailing Address - Street 1:9516 CORTEZ RD W STE 4
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-1800
Mailing Address - Country:US
Mailing Address - Phone:941-213-9371
Mailing Address - Fax:
Practice Address - Street 1:9516 CORTEZ RD W STE 4
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-1800
Practice Address - Country:US
Practice Address - Phone:941-213-9371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center