Provider Demographics
NPI:1508893777
Name:SOTO, ANGEL LUIS (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:LUIS
Last Name:SOTO
Suffix:
Gender:M
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 1:90 CARR 165 STE 504
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-8067
Mailing Address - Country:US
Mailing Address - Phone:787-708-7777
Mailing Address - Fax:787-708-6779
Practice Address - Street 1:90 CARR 165 STE 504
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8067
Practice Address - Country:US
Practice Address - Phone:787-708-6777
Practice Address - Fax:787-708-6779
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13644208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH55736Medicare UPIN
PR0020597Medicare PIN