Provider Demographics
NPI:1700523602
Name:COTO-MADRIGAL, MARIA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ALEJANDRA
Last Name:COTO-MADRIGAL
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 1:2002 RICHARD JONES RD STE C300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2867
Mailing Address - Country:US
Mailing Address - Phone:615-613-3969
Mailing Address - Fax:
Practice Address - Street 1:1180 N INDIAN CANYON DR STE W201
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4876
Practice Address - Country:US
Practice Address - Phone:604-164-5757
Practice Address - Fax:760-416-4577
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4990363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty