Provider Demographics
NPI:1598891707
Name:SOTOLONGO, KATHY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:
Last Name:SOTOLONGO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 VIA REGINA
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3915
Mailing Address - Country:US
Mailing Address - Phone:561-393-3672
Mailing Address - Fax:561-393-3672
Practice Address - Street 1:6605 VIA REGINA
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3915
Practice Address - Country:US
Practice Address - Phone:561-393-3672
Practice Address - Fax:561-393-3672
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist