Healthcare Provider Details

I. General information

NPI: 1508781139
Provider Name (Legal Business Name): LYDIA ALVAREZ COTTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB FOREST VIEW CALLE SOFIA H-234
BAYAMON PR
00956
US

IV. Provider business mailing address

RR 5 BOX 8358
BAYAMON PR
00956-9720
US

V. Phone/Fax

Practice location:
  • Phone: 787-349-9244
  • Fax:
Mailing address:
  • Phone: 787-349-9244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number000398
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: