Provider Demographics
NPI:1508003609
Name:SOTO-DELGADO, JENNIFER (RPT/MPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SOTO-DELGADO
Suffix:
Gender:F
Credentials:RPT/MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. MIRAFLORES
Mailing Address - Street 2:C/ TULIPAN 31069
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:UM
Mailing Address - Phone:787-607-7623
Mailing Address - Fax:787-626-6411
Practice Address - Street 1:URB. MIRAFLORES
Practice Address - Street 2:C/ TULIPAN 31069
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:UM
Practice Address - Phone:787-607-7623
Practice Address - Fax:787-626-6411
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001331172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist