MEDICARE: MIRIAM COTTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	3522	PR

General Provider Information

NPI Number	:	1760369003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM COTTO

Provider Business Mailing Address
First Line	:	19 CALLE ACUARIO # URB
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4933
Country	:	US
Telephone Number	:	787-406-4445
Fax Number	:	787-406-4445

Provider Business Practice Location Address
First Line	:	URB VENUS GARDENS
Second Line	:	805 CALLE ENEAS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4933
Country	:	US
Telephone Number	:	787-406-4445
Fax Number	:	787-406-4445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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Directions to “ MIRIAM COTTO ” Practice Location

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