Provider Demographics
NPI:1437125143
Name:SOTO-MALAVE, RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:SOTO-MALAVE
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 1:3601 FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3795
Mailing Address - Country:US
Mailing Address - Phone:305-576-6611
Mailing Address - Fax:786-476-2845
Practice Address - Street 1:2901 CORAL HILLS DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4146
Practice Address - Country:US
Practice Address - Phone:954-345-0404
Practice Address - Fax:954-688-3150
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8204207R00000X, 207RI0200X
FLME129071207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1014OtherINTMEDCARD PROVIDER NO
FL024235800Medicaid
PR080031OtherPROVIDER NO CRUZ AZUL
PR6100016OtherHUMANA PROVIDER NO