Provider Demographics
NPI:1225689094
Name:CHEO COTO, JULIO CESAR
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:CHEO COTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15945 SW 240TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031-1334
Mailing Address - Country:US
Mailing Address - Phone:786-768-1776
Mailing Address - Fax:
Practice Address - Street 1:15945 SW 240TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33031-1334
Practice Address - Country:US
Practice Address - Phone:786-768-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT1872502106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty