Individual provider Active NPI

Kevin Lee Cortes Gonzalez, MD

  • Student in an Organized Health Care Education/Training Program
  • Fort Lauderdale, FL
National Provider Identifier
1366081275
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone
(954) 355-4400
NPI assigned
Dec 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

Mailing address

PO Box 2137
Arecibo, PR 00613-2137
Phone (787) 237-5493

Other practice location 1

Avenida Severiano Cuevas #18 Km 141.1 Bo Caimital Bajo
Aguadilla, PR 00603
Phone (787) 658-0000 ext. 1019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1366081275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2137",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006132137",
            "telephone_number": "787-237-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Avenida Severiano Cuevas #18 Km 141.1 Bo Caimital Bajo",
            "address_purpose": "LOCATION",
            "city": "Aguadilla",
            "state": "PR",
            "postal_code": "00603",
            "country_code": "US",
            "telephone_number": "787-658-0000 x1019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORTES GONZALEZ",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-26",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.