Provider Demographics
NPI:1346663937
Name:CENTRO PEDIATRICO COTO PSC
Entity Type:Organization
Organization Name:CENTRO PEDIATRICO COTO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-636-9217
Mailing Address - Street 1:PO BOX 801220
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1220
Mailing Address - Country:US
Mailing Address - Phone:787-636-9217
Mailing Address - Fax:787-837-4000
Practice Address - Street 1:7 CALLE LA CRUZ
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2426
Practice Address - Country:US
Practice Address - Phone:787-837-4000
Practice Address - Fax:787-837-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6715208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty