Provider Demographics
NPI:1750304911
Name:SOTO, PABLO SOTO (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:SOTO
Last Name:SOTO
Suffix:
Gender:M
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 1776
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-1776
Mailing Address - Country:US
Mailing Address - Phone:787-892-1883
Mailing Address - Fax:
Practice Address - Street 1:EDIF. RALI 1ER PISO SUITE 104
Practice Address - Street 2:CALLE LUNA #187
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-899-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6214207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR97637Medicare ID - Type Unspecified