Provider Demographics
NPI:1407299134
Name:SOTO, ELIZABETH (BA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ELIZABETH SOTO
Mailing Address - Street 1:1221 SW 132ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1917
Mailing Address - Country:US
Mailing Address - Phone:786-431-6667
Mailing Address - Fax:
Practice Address - Street 1:1221 SW 132ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1917
Practice Address - Country:US
Practice Address - Phone:786-431-6667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS300-220-76-7640103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst