Provider Demographics
NPI:1376241703
Name:SOTO, MAGALY JANET (PA)
Entity Type:Individual
Prefix:
First Name:MAGALY
Middle Name:JANET
Last Name:SOTO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144055
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4055
Mailing Address - Country:US
Mailing Address - Phone:787-878-5757
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA MIRAMAR CARRETERA #2 ESTATAL KM 78.7
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614-4055
Practice Address - Country:US
Practice Address - Phone:787-878-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1193363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical