Healthcare Provider Details

I. General information

NPI: 1033210950
Provider Name (Legal Business Name): CARMEN WALESKA COTTO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 AVE HOSTOS STE 1
MAYAGUEZ PR
00682-6326
US

IV. Provider business mailing address

2625 AVE HOSTOS STE 1
MAYAGUEZ PR
00682-6326
US

V. Phone/Fax

Practice location:
  • Phone: 787-565-7375
  • Fax:
Mailing address:
  • Phone: 787-565-7375
  • Fax: 787-960-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License Number16479
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number16479
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: