Provider Demographics
NPI:1194032474
Name:SOTO, ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 PASEO DE LA CEIBA
Mailing Address - Street 2:CALLE EUCALIPTO 348
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-7430
Mailing Address - Country:US
Mailing Address - Phone:787-653-6929
Mailing Address - Fax:787-653-6948
Practice Address - Street 1:PASEO DE LA CEIBA 348
Practice Address - Street 2:348 CALLE EUCALIPTO
Practice Address - City:JUNCOS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00777-7430
Practice Address - Country:UM
Practice Address - Phone:787-653-6929
Practice Address - Fax:787-653-6948
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4531OtherLICENSE