Provider Demographics
NPI:1417072489
Name:SOTO, ROSA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WINSTON CHURCHILL AVE.
Mailing Address - Street 2:VILLAS DEL SENORIAL 905
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-755-3708
Mailing Address - Fax:
Practice Address - Street 1:60 AVE WINSTON CHURCHILL
Practice Address - Street 2:APT. 905 VILLAS DEL SENORIAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6704
Practice Address - Country:US
Practice Address - Phone:787-755-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5664208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics