Organization
COTELO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMIAN A DIAZ COTELO MD (MANAGER)
(786) 474-4345
Entity
Organization
Contact information
Practice address
11767 S DIXIE HWY, 423, PINECREST, FL 33156-4438
(786) 474-4345
(855) 268-3561
Mailing address
11767 S DIXIE HWY, 423, PINECREST, FL 33156-4438
(786) 474-4345
(855) 268-3561
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME105957
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME105957
MEDICAL LICENSE
FL
Enumeration date
06/27/2011
Last updated
09/26/2012
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