Provider Demographics
NPI:1699220848
Name:COTTO, HERIBERTO JR
Entity Type:Individual
Prefix:MR
First Name:HERIBERTO
Middle Name:
Last Name:COTTO
Suffix:JR
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 1:16336 NW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1782
Mailing Address - Country:US
Mailing Address - Phone:954-873-0025
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 36TH ST
Practice Address - Street 2:UNIT 404
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6645
Practice Address - Country:US
Practice Address - Phone:866-305-7365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor