Provider Demographics
NPI:1689019028
Name:SOTO-MORENO, KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:SOTO-MORENO
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 154
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0154
Mailing Address - Country:US
Mailing Address - Phone:787-224-7777
Mailing Address - Fax:
Practice Address - Street 1:CARR. 402 KM 1.8
Practice Address - Street 2:ZONA INDUSTRIAL BO MARIAS
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0001
Practice Address - Country:US
Practice Address - Phone:787-224-7777
Practice Address - Fax:787-844-6888
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR019491207RC0000X
PR19491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease