Provider Demographics
NPI:1447211347
Name:OLIVERAS SOTO, GILBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:
Last Name:OLIVERAS SOTO
Suffix:
Gender:M
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:PO BOX 71325
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8425
Mailing Address - Country:US
Mailing Address - Phone:787-767-0102
Mailing Address - Fax:787-769-2062
Practice Address - Street 1:HOSP SAN FRANCISCO
Practice Address - Street 2:AVE D DE DIEGO 371
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-767-0102
Practice Address - Fax:787-767-1899
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9387173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89296OtherTRIPLES
PRP267OtherINTERNATIONAL MEDICAL CAR
PR601227OtherMMM
PR100181OtherCRUZ AZUL
PR9180393OtherHUMANA
PRPE4669OtherPALIC
PR89296Medicare ID - Type UnspecifiedMEDICARE OPTIMO
PR0089296Medicare ID - Type Unspecified