Provider Demographics
NPI:1225297914
Name:SOTO, BARRY D
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:SOTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 CALLE ROMERILLO
Mailing Address - Street 2:URB. SANTA MARIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6624
Mailing Address - Country:US
Mailing Address - Phone:787-371-2120
Mailing Address - Fax:
Practice Address - Street 1:107 CALLE HIJA DEL CARIBE
Practice Address - Street 2:URB. EL VEDADO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3204
Practice Address - Country:US
Practice Address - Phone:787-641-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR170152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist