Provider Demographics
NPI:1679558845
Name:SOTO, ANA MERCEDES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MERCEDES
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3974
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3974
Mailing Address - Country:US
Mailing Address - Phone:787-384-3458
Mailing Address - Fax:787-254-2728
Practice Address - Street 1:445 AVE GONZALEZ CLEMENTE
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1136
Practice Address - Country:US
Practice Address - Phone:787-384-3458
Practice Address - Fax:787-254-2728
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-10
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29797Medicare ID - Type Unspecified
PRE66291Medicare UPIN