Provider Demographics
NPI:1578847018
Name:DR ANITA M SOTO O.D. INC.
Entity Type:Organization
Organization Name:DR ANITA M SOTO O.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-237-9120
Mailing Address - Street 1:6785 WALLINGS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3024
Mailing Address - Country:US
Mailing Address - Phone:440-237-9120
Mailing Address - Fax:440-237-9124
Practice Address - Street 1:6785 WALLINGS RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3024
Practice Address - Country:US
Practice Address - Phone:440-237-9120
Practice Address - Fax:440-237-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4850 T1715152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty