Provider Demographics
NPI:1790478279
Name:SOTO, DOLORES M (AA)
Entity Type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:M
Last Name:SOTO
Suffix:
Gender:F
Credentials:AA
Other - Prefix:MRS
Other - First Name:DOLORES
Other - Middle Name:M
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA
Mailing Address - Street 1:HC 10 BOX 193
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-9733
Mailing Address - Country:US
Mailing Address - Phone:787-519-5812
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1823
Practice Address - Country:US
Practice Address - Phone:787-519-5812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech