Provider Demographics
NPI:1740397439
Name:NIEVES SOTO, ELSA (RPT, MPT)
Entity Type:Individual
Prefix:MRS
First Name:ELSA
Middle Name:
Last Name:NIEVES SOTO
Suffix:
Gender:F
Credentials:RPT, MPT
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 144036
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4036
Mailing Address - Country:US
Mailing Address - Phone:787-235-7516
Mailing Address - Fax:787-881-5572
Practice Address - Street 1:CARR 2 KM 62.8
Practice Address - Street 2:SECTOR CANDELARIA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-235-7516
Practice Address - Fax:787-881-5572
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR51040OtherPREFERRED MEDICARE CHOICE
PR57142OtherSSS SELECTO / OPTIMO
PR6120247OtherHUMANA
PR870090OtherMEDICARE Y MUCHO MAS
PR57142Medicare UPIN