Provider Demographics
NPI:1538302575
Name:SOTO, LESLIE K (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:K
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:K
Other - Last Name:SOTO-GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2020 PMB 121
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2020
Mailing Address - Country:US
Mailing Address - Phone:787-412-6733
Mailing Address - Fax:
Practice Address - Street 1:SECTOR LAS CANELAS
Practice Address - Street 2:CALLE SANTA TERESA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:747-412-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17170208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice