Raisa Cortes Fontanet

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN24362 Issued in FL

Practice address

747 Ponce de Leon Blvd
Coral Gables, FL 33134-2049

Phone

(305) 444-8591

NPI assigned

Jul 22, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vidamax Dental Group Corp

  • Dental Clinic/Center
  • Hollywood, FL
  • NPI 1417604166
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1124505268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SW 2ND AVE UNIT 1002",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331303594",
            "telephone_number": "786-715-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342049",
            "telephone_number": "305-444-8591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331252738",
            "country_code": "US",
            "telephone_number": "305-649-6112",
            "fax_number": "305-649-1803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330206930",
            "country_code": "US",
            "telephone_number": "754-348-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORTES FONTANET",
        "first_name": "RAISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-22",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corposchema Pilates & Rehab, Inc.
• Gabriela Correa Gonzalez, RN
• Deborah Correa Herrera, LMHC
• Adrian Jasen Correa, DMD
• Corsar Dental II, PA
• Annabella Jezelle Cortez
• Courtney Rae Cortez
• Leah Cortez
• Natalie I. Cortina, PA-C
• Alejandra Corvalan Nunez

• General Practice Dentistry in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.