Provider Demographics
NPI:1790574879
Name:COTTO MONTANEZ, RAIZA
Entity type:Individual
Prefix:
First Name:RAIZA
Middle Name:
Last Name:COTTO MONTANEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CALLE MARLIN
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9824
Mailing Address - Country:US
Mailing Address - Phone:787-402-9868
Mailing Address - Fax:
Practice Address - Street 1:100 AVE. LUIS MUNOZ MARIN, TORRE MEDICA 2DO PISO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-745-0340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist