Provider Demographics
NPI:1093435406
Name:SOTO VARGAS, RAQUEL (MD)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:
Last Name:SOTO VARGAS
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:HC 1 BOX 8071
Mailing Address - Street 2:CAR # 2 KM 84 H0 INT
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-7361
Mailing Address - Country:US
Mailing Address - Phone:939-277-8510
Mailing Address - Fax:
Practice Address - Street 1:CAR #2 K84 H0 INT BO CARRIZALES SECTOR QUINTO SOTO
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-7361
Practice Address - Country:US
Practice Address - Phone:939-277-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22948208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice