Provider Demographics
NPI:1265534424
Name:COTTO HERNANDEZ, JOSEFA (MD)
Entity type:Individual
Prefix:MRS
First Name:JOSEFA
Middle Name:
Last Name:COTTO HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 COCO PLUMOROSO
Mailing Address - Street 2:URB BOSQUE DE LAS PALMAS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-9250
Mailing Address - Country:US
Mailing Address - Phone:787-630-3207
Mailing Address - Fax:
Practice Address - Street 1:CALLE 54 SE 1277
Practice Address - Street 2:URB LA RIVIERA
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-781-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14291208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
I01020Medicare UPIN
0022024Medicare ID - Type Unspecified