Provider Demographics
NPI:1033210950
Name:COTTO, CARMEN WALESKA (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:WALESKA
Last Name:COTTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2625 AVE HOSTOS STE 1
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6326
Mailing Address - Country:US
Mailing Address - Phone:787-565-7375
Mailing Address - Fax:787-960-2223
Practice Address - Street 1:103 JUAN L. RAMOS
Practice Address - Street 2:FRONTERAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-2913
Practice Address - Country:US
Practice Address - Phone:787-565-7375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16479208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No208000000XAllopathic & Osteopathic PhysiciansPediatrics