Provider Demographics
NPI:1811397680
Name:COTTO CASTELLANO, LYNDA M
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:M
Last Name:COTTO CASTELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PQ-26 AVE. COMANDANTE
Mailing Address - Street 2:COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-752-5111
Mailing Address - Fax:
Practice Address - Street 1:AVE. COMANDANTE PQ-26 CONTRY CLUB
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00985
Practice Address - Country:UM
Practice Address - Phone:787-752-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9172183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician