Provider Demographics
NPI:1386631653
Name:SOTO-AGUILAR, MARIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:SOTO-AGUILAR
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 1:14153 YOSEMITE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8060
Mailing Address - Country:US
Mailing Address - Phone:727-697-2150
Mailing Address - Fax:727-863-4757
Practice Address - Street 1:14153 YOSEMITE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8060
Practice Address - Country:US
Practice Address - Phone:727-697-2150
Practice Address - Fax:727-863-4757
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79740207RA0201X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7049127OtherAETNA
FL259231200Medicaid
FL49628OtherBLUE SHIELD PROVIDER NUMB
FL280536OtherAVMED
FL9255006-001OtherCIGNA
FLF21594Medicare UPIN
FL259231200Medicaid
FL49628Medicare PIN