Healthcare Provider Details

I. General information

NPI: 1306882824
Provider Name (Legal Business Name): HUMBERTO A COTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 N DALE MABRY HWY STE 10
TAMPA FL
33614-3910
US

IV. Provider business mailing address

7001 N DALE MABRY HWY STE 10
TAMPA FL
33614-3910
US

V. Phone/Fax

Practice location:
  • Phone: 813-558-8828
  • Fax: 813-558-8934
Mailing address:
  • Phone: 813-558-8828
  • Fax: 813-558-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0047485
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME47485
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: