Provider Demographics
NPI:1760663884
Name:SOTO-ROSARIO, ANGEL L
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:L
Last Name:SOTO-ROSARIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROAD # 682 KM 9.8 STREET 3 HOUSE 109
Mailing Address - Street 2:FACTOR VILLA GARROCHALES
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00652
Mailing Address - Country:US
Mailing Address - Phone:787-881-0526
Mailing Address - Fax:787-621-5483
Practice Address - Street 1:ROAD # 682 KM 9.8 AVE. 3 HOUSE 109
Practice Address - Street 2:FACTOR VILLA GARROCHALES
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00652-0011
Practice Address - Country:US
Practice Address - Phone:787-881-0526
Practice Address - Fax:787-621-5483
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001616-P146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic