Provider Demographics
NPI:1871211292
Name:MARIN CORTES, CARLOS ERNESTO
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ERNESTO
Last Name:MARIN CORTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION RIO CANAS
Mailing Address - Street 2:CALLE MISSISSIPPI 2715 APT #2
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:910-337-5855
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION RIO CANAS
Practice Address - Street 2:CALLE MISSISSIPPI 2715 APT #2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:910-337-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022928208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice