Provider Demographics
NPI:1073869368
Name:RENTA-SOTO, MARIA DE LOS ANGELES (MD)
Entity Type:Individual
Prefix:
First Name:MARIA DE LOS
Middle Name:ANGELES
Last Name:RENTA-SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CAMINO DEL SUR 421
Mailing Address - Street 2:RUISENOR
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB CAMINO DEL SUR 421
Practice Address - Street 2:RUISENOR
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2826
Practice Address - Country:US
Practice Address - Phone:787-475-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28980-R208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice