Provider Demographics
NPI:1861402968
Name:CORTES, ROSA ANNA (RPT)
Entity type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:ANNA
Last Name:CORTES
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CALLE PROVIDENCIA
Mailing Address - Street 2:REPARTO LOPEZ
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5746
Mailing Address - Country:US
Mailing Address - Phone:787-882-2138
Mailing Address - Fax:787-823-4306
Practice Address - Street 1:18 CALLE COMERCIO
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677-2201
Practice Address - Country:US
Practice Address - Phone:787-823-4306
Practice Address - Fax:787-823-3880
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083804Medicare PIN