Provider Demographics
NPI:1558914853
Name:DR SOTO MEDICAL PSC
Entity Type:Organization
Organization Name:DR SOTO MEDICAL PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOTO CARRIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-634-2917
Mailing Address - Street 1:HC2 BOX 120697
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-634-2917
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO PLAZA QUINTANA
Practice Address - Street 2:CARR 111 KM 11.5 BO CAPA
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-658-6142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care