Provider Demographics
NPI:1235320086
Name:COTTO OYOLA, WILMA L (MD)
Entity Type:Individual
Prefix:DR
First Name:WILMA
Middle Name:L
Last Name:COTTO OYOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WILMA
Other - Middle Name:L
Other - Last Name:COTTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1353 AVE LUIS VIGOREAUX
Mailing Address - Street 2:PMB 633
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2715
Mailing Address - Country:US
Mailing Address - Phone:787-798-5998
Mailing Address - Fax:787-780-0971
Practice Address - Street 1:CALLE SANTA CRUZ, EDIF. MEDICO SANTA CRUZ #73
Practice Address - Street 2:SUITE 213
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7052
Practice Address - Country:US
Practice Address - Phone:787-798-5998
Practice Address - Fax:787-780-0971
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.025265207RG0100X
PR14840207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1421201Medicaid
MS00270331Medicaid
MS00270331Medicaid
LA1421201Medicaid
LAI07330Medicare UPIN