Provider Demographics
NPI:1144625666
Name:COTTO, JOAQUIN (SLP)
Entity type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:
Last Name:COTTO
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2963
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-2963
Mailing Address - Country:US
Mailing Address - Phone:787-276-8123
Mailing Address - Fax:787-257-2179
Practice Address - Street 1:27-16 AVE ROBERTO CLEMENTE
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5420
Practice Address - Country:US
Practice Address - Phone:787-276-8123
Practice Address - Fax:787-257-2179
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist