| Cotelo Llc | |
|
11767 S Dixie Hwy 423 Pinecrest FL 33156-4438 | |
| (786) 474-4345 | |
| (855) 268-3561 |
| Full Name | Cotelo Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11767 S Dixie Hwy, Pinecrest, Florida |
| Authorized Official Name and Position | Damian A Diaz Cotelo (MANAGER) |
| Authorized Official Contact | 7864744345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cotelo Llc 11767 S Dixie Hwy 423 Pinecrest FL 33156-4438 Ph: (786) 474-4345 | Cotelo Llc 11767 S Dixie Hwy 423 Pinecrest FL 33156-4438 Ph: (786) 474-4345 |
| NPI Number | 1285920363 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 09/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285920363 | NPI | - | NPPES |
| ME105957 | Other | FL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME105957 (Florida) | Primary |
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