Provider Demographics
NPI:1568580553
Name:SOTO LOPEZ, ANEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANEL
Middle Name:G
Last Name:SOTO LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:931 W OAK ST
Mailing Address - Street 2:STE 103
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4973
Mailing Address - Country:US
Mailing Address - Phone:407-931-0444
Mailing Address - Fax:407-962-4446
Practice Address - Street 1:5425 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1748
Practice Address - Country:US
Practice Address - Phone:407-931-0444
Practice Address - Fax:407-674-7887
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15200208D00000X
FLACN780208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIN031ZMedicare PIN
PRI-43978Medicare UPIN