Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15140 | PR |
NPI | 1033214788 |
---|---|
Provider Name | Dr. Cibeles Cotto |
First Address | Bayamon, PR 00960-8376 |
Second Address | Trujillo Alto, PR 00976-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |