Provider Demographics
NPI:1508276650
Name:SANTA, EILEEN SOTO (MPT)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:SOTO
Last Name:SANTA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE MAGA D-4
Mailing Address - Street 2:URBANIZACION UNIVERSITY GARDENS
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-675-2499
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA MIRAMAR #1141 CARRETERA #2
Practice Address - Street 2:KM 79.4
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-1480
Practice Address - Fax:788-817-0598
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist