Provider Demographics
NPI:1659754364
Name:LEBRON SOTO, KARLA YAMILKA (LOTA)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:YAMILKA
Last Name:LEBRON SOTO
Suffix:
Gender:F
Credentials:LOTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BO CALZADA
Mailing Address - Street 2:
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707-2706
Mailing Address - Country:US
Mailing Address - Phone:787-485-1701
Mailing Address - Fax:
Practice Address - Street 1:47 BO CALZADA
Practice Address - Street 2:
Practice Address - City:MAUNABO
Practice Address - State:PR
Practice Address - Zip Code:00707-2706
Practice Address - Country:US
Practice Address - Phone:787-485-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR758224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant