Organization
CORTEZ KNEE AND SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN D BOWES (CFO)
(941) 792-0506
Entity
Organization
Contact information
Practice address
6203 CORTEZ RD W, BRADENTON, FL 34210-2602
(941) 782-0490
(941) 792-0496
Mailing address
6203 CORTEZ RD W, BRADENTON, FL 34210-2602
(941) 792-0506
(941) 792-0506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC10324
HEALTH CARE CLINIC LICENSE
FL
Enumeration date
03/10/2015
Last updated
04/23/2015
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