Provider Demographics
NPI:1275821050
Name:SOTO RAMOS, ANTONIO R
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:R
Last Name:SOTO RAMOS
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 1:710 OAK COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4100
Mailing Address - Country:US
Mailing Address - Phone:407-846-6747
Mailing Address - Fax:407-846-6186
Practice Address - Street 1:710 OAK COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4100
Practice Address - Country:US
Practice Address - Phone:407-846-6747
Practice Address - Fax:407-846-6186
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19053207R00000X
FL135194207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine