Healthcare Provider Details

I. General information

NPI: 1144625666
Provider Name (Legal Business Name): JOAQUIN COTTO SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27-16 AVE ROBERTO CLEMENTE
CAROLINA PR
00985-5420
US

IV. Provider business mailing address

PO BOX 2963
CAROLINA PR
00984-2963
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-8123
  • Fax: 787-257-2179
Mailing address:
  • Phone: 787-276-8123
  • Fax: 787-257-2179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2032
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: