Provider Demographics
NPI:1508972373
Name:SOTO RODRIGUEZ, ZY A (MD)
Entity Type:Individual
Prefix:DR
First Name:ZY
Middle Name:A
Last Name:SOTO RODRIGUEZ
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 1:6307 SWANSON ST
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-4118
Mailing Address - Country:US
Mailing Address - Phone:787-376-4194
Mailing Address - Fax:
Practice Address - Street 1:17410 HWY 50
Practice Address - Street 2:STE 110
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8188
Practice Address - Country:US
Practice Address - Phone:407-240-2361
Practice Address - Fax:407-345-8895
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16501208D00000X
FLACN585208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16501OtherMEDICINE DOCTOR LICENSE