Provider Demographics
NPI:1518358852
Name:SOTO, LYDIA (FNP)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 CALLE MADRID
Mailing Address - Street 2:MANSIONES DE MONTEREY
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-2571
Mailing Address - Country:US
Mailing Address - Phone:787-543-2471
Mailing Address - Fax:
Practice Address - Street 1:593 CALLE MADRID
Practice Address - Street 2:MANSIONES DE MONTEREY
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-2571
Practice Address - Country:US
Practice Address - Phone:787-543-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily