Basic Information
| Provider Information | |||||||||
| NPI: | 1831171636 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIVERA COTTO | ||||||||
| FirstName: | ANGEL | ||||||||
| MiddleName: | RAUL | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | SR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1582 | ||||||||
| Address2: | |||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877358595 | ||||||||
| FaxNumber: | 7877354887 | ||||||||
| Practice Location | |||||||||
| Address1: | AVE. MAIN BLOQUE 51 #39 SANTA ROSA | ||||||||
| Address2: | |||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877985615 | ||||||||
| FaxNumber: | 7877869046 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2005 | ||||||||
| LastUpdateDate: | 05/02/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 6462 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.